 Some members of the U.S. Supreme Court invoked double effect as a justification for the administration of pain-relieving drugs to patients receiving palliative care and also as a justification for the practice known as terminal sedation in which sedative drugs are administered to patients with intractable and untreatable pain in order to induce unconsciousness (Vacco et al. v. Quill et al., 117 S.Ct. 2293 (1997)). If artificial hydration and nutrition are not provided, sedation undertaken to deal with intractable pain may well hasten death. (If death is immediately imminent, then the absence of hydration and nutrition may not affect the time of death.) The most plausible and defensible version of the principle of double effect requires that the harmful side effect be minimized, so the principle of double effect provides no justification for withholding hydration and nutrition in cases in which death is not immediately imminent. The decision to withhold hydration and nutrition seems to depend on a judgment that death would not be a harm to the patient who has been sedated. In circumstances in which it would not be a harm to cause a person’s death, the principle of double effect does not apply.