592:
658:
33:
47:
725:
seek to respect the wishes of the patient, believing that they are better able to decide what is in the patient's best interests. The doctor has no right to make important decisions on behalf of competent patients, as a general principle. Even where the doctor acts in the patient's interests, it is important that the patient's own choices and wishes be respected.
873:—who performs the act—from the moral judgements; in order to see what is good and not merely what are the rights involved, we must consider the virtue and intentions of the person acting. For example, Häyry (2003), in his scrutiny of the objection that the "Georgetown principles" are not truly representative of European values (being more aligned with
688:, but it is not aligned to any one single theory. Whilst Beauchamp and Childress claim that these principles are commonly understood and accepted within society—and thus have a broad degree of support—they also assert that they are drawn from two normative ethical traditions: the duty-based moral philosophy (
792:
that the epistemic origins and justifications of these principles be established. Rather the sufficient condition is that most individuals and societies, would agree that both prescriptively and descriptively there is wide agreement with the existence and acceptance of the general values of autonomy,
724:
This principle refers to the capacity of an individual to be self-determining and to make decisions for themselves without undue pressure, coercion or other forms of persuasion. It is contrasted with the notion of paternalism which occurs when actions of a health care practitioner override or do not
865:
Others have objected to the choice or limitations of the particular principles, such as
Herissone-Kelly (2003), who questions the argument that Beauchamp and Childress present in support of their global applicability; and Walker (2009), who believes that more principles need to be added if they are
744:
This principle describes an obligation to act for the benefit of others. Acting in this way might involve preventing or removing harm, or it might involve the active promotion of some good (e.g., health). The aim of beneficent action is to produce the "best" one can out of a range of possibilities.
861:, and the like—and say, in effect, choose whichever of the competing theories, maxims, principles, or rules suits you for any particular case. Just take your choice! They each have flaws—which are always pointed out—but on balance, the authors seem to be saying, they are probably all equally good!
762:
The principle of justice requires that we do what we can to ensure that costs and benefits are fairly distributed. It is possible to obey the principle of non-maleficence and the principle of beneficence, yet still not behave in an ethical manner, for these two principles say nothing about how
775:
that focuses on the common-ground moral principles of autonomy, beneficence, nonmaleficence, and justice. The practicality of this approach is that principlism can be derived from, is consistent with, or at the very least is not in conflict with a multitude of ethical, theological, and social
753:
Duties of non-maleficence require us to refrain from causing deliberate harm or intentional avoidance of actions that might be expected to cause harm. Generally, obligations of non-maleficence are more stringent than obligations of beneficence, but again a cost/benefit analysis may need to be
836:
Clouser and Gert assert that the principled approach lacks theoretical unity; the principles lack any systematic relationship because they are drawn from conflicting moral theories, and hence often lead to conflicting conclusions. The apparent "pick and mix" selection of certain theories and
763:
benefits should be apportioned. In a given case it may well be that we can only procure a major benefit for some people by slightly harming the interests of others. The principle of beneficence may say we should go ahead, but then the benefits and costs would be unfairly distributed.
654:, and justice. In the opinion of Beauchamp and Childress, these four principles are part of a "common morality;" an approach that "takes its basic premises directly from the morality shared by the members of society—that is, unphilosophical common sense and tradition."
564:
centering the application of certain ethical principles. This approach to ethical decision-making has been prevalently adopted in various professional fields, largely because it sidesteps complex debates in moral philosophy at the theoretical level.
600:
745:
It can involve cost/benefit analysis such that the "best" here will be the possible action in which the benefits produced maximally outweigh the costs or the risks. Put simply, it is to act always in the best interests of the patient.
881:
By ignoring moral (and religious) virtues, and thereby all deliberations about the ideal nature of a good, virtuous human being, Beauchamp and
Childress left their views wide open to accusations of short-sighted
926:
analysis, the perceived benefits have been significant as evidenced by its pervasive use. Principlism is by far the most dominant approach to ethical analysis in healthcare and the book
591:
784:
groups by definition cannot agree on particular moral theories or their epistemic justifications. However, pluralistic interdisciplinary groups can and do agree on
716:
These ethical principles can be elucidated in slightly different ways, but the explanations provided by
Beauchamp and Childress can be summarised as follows.
754:
undertaken to identify the best possible action. In some situations harm may be unavoidable and then we must be sure that the benefits outweigh the harm.
845:
espoused (perhaps unwittingly) by many books (usually anthologies) of bioethics. They parade before the reader a variety of "theories" of ethics—
95:
999:
Department of Health, E. (2014). "The
Belmont Report. Ethical principles and guidelines for the protection of human subjects of research."
588:
The origins of principlism, as we know it today, are to be found in two influential publications from the late 1970s in the United States.
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613:(Pub. L. 93-348) was signed into law. After four years of monthly deliberations, the Commission met in February 1976 for four days at the
57:
1111:
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1203:
1153:
789:
1296:. 2003. "Ethics needs principles—four can encompass the rest—and respect for autonomy should be 'first among equals'."
1244:
526:
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568:
Rather than engaging in abstract debate about the best or most appropriate approach at the normative level (e.g.,
362:
1166:
Herissone-Kelly, P. 2003. "The principlist approach to bioethics and its stormy journey overseas." Pp. 65–77 in
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is essential when making moral decisions institutionally, pedagogically, and in the community as pluralistic
105:
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principles, without an underlying theoretical basis, is a cause of great concern for
Clouser who states:
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181:
119:
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Additionally, it has been suggested, that application of a principlist approach serves to exclude the
1328:
1323:
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who has claimed that the four principles can explain and justify all the substantive moral claims in
580:), principlism is purported to offer a practical method of dealing with real-world ethical dilemmas.
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124:
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itself was first presented, not by
Beauchamp and Childress, but by two of the most vocal critics,
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1024:
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principles lie at the core of moral reasoning in health care: respect for autonomy, beneficence,
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617:'s Belmont Conference Center which resulted in a statement of three basic ethical principles:
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National
Commission for the Protection of Human Subjects of Biomedical and Behavioral Research
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877:), points to the lack of representation of virtue ethics within their chosen principles:
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by
Beauchamp and Childress remains the most influential book in modern bioethics.
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1043:
1016:
980:
Handbook of
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651:
637:
546:"Principlist" redirects here. For the faction in post-1979 Iranian politics, see
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Häyry, M. 2003. "European values in bioethics: why, what, and how to be used?"
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principles. In the development of a principlistic moral framework it is not a
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On the other hand, there are also staunch supporters of principlism such as
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Beauchamp T. L., and D. DeGrazia. 2004. "Principles and
Principlism." In
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Principlism has been subjected to challenges since its introduction by
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Respect for autonomy is operationalised through the requirement for
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Hain, R., and T. Saad. 2016. "Foundations of practical ethics."
607:". The Commission came into existence on July 12, 1974 when the
673:, so-called because both Beauchamp and Childress were based at
375:
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must be fully informed before being asked for their consent.
380:
1151:. 1995. "Common Morality as an Alternative to Principlism."
922:
In spite of any shortcomings of the principlist approach in
771:
Principlism has evolved into a practical approach for
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The four principles are sometimes referred to as the
644:(1979), in which they state that the following four
632:The approach was introduced for the second time by
911:. According to Gillon, these principles provide a
1310:
1066:"Ethical Considerations in Trauma-Informed Care"
1001:The Journal of the American College of Dentists
776:approaches towards moral decision-making. This
1170:, edited by M. Häyry and T. Takala. New York:
866:truly to represent a common sense morality.
527:
1280:. 1998. "Bioethics overview." Pp. 305–17 in
1183:Walker, T. 2009. "What principlism misses."
629:, for biomedical and behavioural research.
793:nonmaleficence, beneficence, and justice.
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534:
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732:whereby people who have the capacity for
684:The principlist approach is derived from
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599:The approach was first advocated by the
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1035:
1033:
711:
1109:. 1990. "A critique of principlism."
986:78), edited by G. Khushf. Dordrecht:
1070:Psychiatric Clinics of North America
796:Principlism is a useful addition to
1168:Scratching the Surface of Bioethics
1154:Kennedy Institute of Ethics Journal
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13:
1245:Theoretical Medicine and Bioethics
1112:Journal of Medicine and Philosophy
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1204:Whose Justice? Which Rationality?
501:Social and political philosophers
1262:Principles of Health Care Ethics
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1048:Principles of Biomedical Ethics
1021:Principles of Biomedical Ethics
928:Principles of Biomedical Ethics
679:Principles of Biomedical Ethics
642:Principles of Biomedical Ethics
560:approach to the examination of
1282:Encyclopedia of Applied Ethics
1231:University of Notre Dame Press
1209:University of Notre Dame Press
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993:
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1:
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661:Georgetown University campus
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677:when the first edition of
603:in a document called the "
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545:
1299:Journal of Medical Ethics
1186:Journal of Medical Ethics
1082:10.1016/j.psc.2021.07.001
948:Encyclopedia of Bioethics
696:; and the outcome-based (
686:normative ethical thought
248:Middle Eastern philosophy
1133:Morality vs. Principlism
1064:Rudolph, Kaila (2021).
1052:Oxford University Press
1025:Oxford University Press
984:Philosophy and Medicine
956:. Accessed 21 May 2019.
773:ethical decision-making
767:As a practical approach
615:Smithsonian Institution
578:consequentialist ethics
896:
863:
690:deontological approach
662:
596:
471:Aesthetic philosophers
1248:24(3):199–214. p.201.
1050:(5th ed.). New York:
879:
839:
804:As a matter of debate
675:Georgetown University
667:Georgetown principles
660:
610:National Research Act
594:
52:Philosophy portal
1157:5(3):219–36. p. 224.
798:trauma-informed care
778:pluralistic approach
720:Respect for autonomy
548:Iranian Principlists
496:Philosophers of mind
1221:MacIntyre, Alasdair
1199:MacIntyre, Alasdair
1137:John Wiley and Sons
875:American liberalism
790:necessary condition
712:The four principles
595:The Belmont Report.
506:Women in philosophy
236:Indigenous American
19:Part of a series on
1149:Clouser, K. Danner
1125:Clouser, K. Danner
1103:Clouser, K. Danner
1044:James F. Childress
1017:James F. Childress
946:"Principlism." In
816:in 1979. The term
734:self-determination
663:
597:
199:Eastern philosophy
1040:Beauchamp, Tom L.
1013:Beauchamp, Tom L.
857:, other forms of
822:K. Danner Clouser
782:interdisciplinary
671:Georgetown mantra
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859:consequentialism
841:It is a kind of
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120:Ancient Egyptian
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681:was published.
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1076:(4): 521–535.
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969:44(10):578–82.
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558:applied ethics
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463:Philosophers
371:Epistemology
192:South Africa
147:Contemporary
96:Philosophies
1229:. Indiana:
1207:. Indiana:
1003:, 81(3), 4.
871:moral agent
818:principlism
740:Beneficence
647:prima facie
623:beneficence
554:Principlism
386:Metaphysics
301:By religion
157:Continental
137:Renaissance
1313:Categories
934:References
924:bioethical
851:deontology
847:Kantianism
843:relativism
574:deontology
394:Aesthetics
83:Categories
25:Philosophy
1046:. 2001.
1027:. p. 100.
1019:. 1994.
832:Criticism
486:Logicians
481:Ethicists
439:Political
399:Education
320:Christian
315:Confucian
214:Indonesia
168:By region
106:By period
1260:. 1994.
1223:. 1988.
1201:. 1984.
1131:. 1994.
1090:34763786
988:Springer
967:Medicine
892:nihilism
884:hedonism
619:autonomy
444:Religion
429:Ontology
409:Language
363:Branches
310:Buddhist
265:American
187:Ethiopia
152:Analytic
132:Medieval
73:Glossary
58:Contents
899:Support
758:Justice
669:or the
627:justice
584:Origins
449:Science
404:History
330:Islamic
290:Russian
285:Italian
270:British
260:Western
253:Iranian
229:Vietnam
204:Chinese
177:African
115:Ancient
78:History
63:Outline
1172:Rodopi
1127:. and
1105:. and
1088:
1042:, and
1015:, and
950:. via
625:, and
556:is an
376:Ethics
345:Taoist
340:Jewish
280:German
275:French
209:Indian
142:Modern
692:) of
381:Logic
325:Hindu
224:Korea
219:Japan
182:Egypt
68:Lists
1086:PMID
824:and
812:and
704:and
636:and
424:Mind
335:Jain
1078:doi
982:, (
576:or
414:Law
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