 A second misinterpretation is fostered by applications of double effect that contrast the permissibility of causing a harm as a merely foreseen side effect of pursuing a good end with the impermissibility of aiming at the same kind of harm as one’s end. Since it is widely accepted that it is wrong to aim to produce harm to someone as an end, to rule this out is not part of double effect’s distinctive content. The principle presupposes that agents do not aim to cause morally grave harms as an end and seeks to guide decisions about causing harm while pursuing a morally good end. For example, double effect contrasts those who would (allegedly permissibly) provide medication to terminally ill patients in order to alleviate suffering with the side effect of hastening death with those who would (allegedly impermissibly) provide medication to terminally ill patients in order to hasten death in order to alleviate suffering. In the allegedly impermissible case, the physician’s ultimate end is a good one — to alleviate suffering — not to cause death. 