Principlism’s Balancing Act: Why the Principles of Biomedical Ethics Need a Theory of the Good

Journal of Medicine and Philosophy 45 (4-5):441-470 (2020)
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Principlism, the bioethical theory championed by Tom Beauchamp and James Childress, is centered on the four moral principles of beneficence, non-maleficence, respect for autonomy, and justice. Two key processes related to these principles are specification—adding specific content to general principles—and balancing—determining the relative weight of conflicting principles. I argue that both of these processes necessarily involve an appeal to human goods and evils, and therefore require a theory of the good. A significant problem with principlism is that it lacks a theory of the good and consequently does not have an adequate solution to the problems of specification and balancing. My conclusion is that principlism must adopt some account of human well-being in order to be a satisfactory bioethical framework.



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Matthew Shea
Franciscan University of Steubenville

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References found in this work

Nicomachean ethics.H. Aristotle & Rackham - 2014 - Indianapolis: Hackett Publishing Co.. Edited by C. D. C. Reeve.
Principles of biomedical ethics.Tom L. Beauchamp - 1979 - New York: Oxford University Press. Edited by James F. Childress.
The virtues in medical practice.Edmund D. Pellegrino - 1993 - New York: Oxford University Press. Edited by David C. Thomasma.

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