Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

Though the revised edition of A Theory of Justice, published in 1999, is the definitive statement of Rawls's view, so much of the extensive literature on Rawls's theory refers to the first edition. This reissue makes the first edition once again available for scholars and serious students of Rawls's work.

‘Why Not Common Morality?’ revisits an important and enduring question: is medical ethics distinct from ‘everyday’ ethics? In her paper, Rosamond Rhodes undertakes the ambitious project of answering this question, in addition to clarifying what constitutes a profession, how professions differ from ‘roles’ and how medical ethics relates to medical professionalism. Rhodes aims to challenge the status quo within medical ethics by departing from the views of certain giants within the field. The paper’s central contention is that the ethics of (...) everyday life and medical ethics are indeed distinct—the latter cannot be derived from the former and we consequently need a new theory of medical ethics. While I am sympathetic to the aims of the project and took no small delight in Rhodes’s gumption, the paper suffers from a number of issues. Putting aside the issue of whether Rhodes accurately represents the theories she critiques—and that is no small thing to set aside—first, many scholars have interrogated in great depth, and from many angles, the relationship between common morality and medical ethics.1–4 Scholarship from the philosophy of medicine, virtue ethics, role-differentiated ethics, narrative and care ethics has made a significant contribution to the projects of clarifying what is distinct about medical professionalism and understanding how we might subsequently treat ethical issues that arise in healthcare with due sensitivity to these myriad differences.5–10 Yet, Rhodes largely ignores this literature …. (shrink)

This paper challenges the long-standing and widely accepted view that medical ethics is nothing more than common morality applied to clinical matters. It argues against Tom Beauchamp and James Childress’s four principles; Bernard Gert, K. Danner Clouser and Charles Culver’s ten rules; and Albert Jonsen, Mark Siegler, and William Winslade’s four topics approaches to medical ethics. First, a negative argument shows that common morality does not provide an account of medical ethics and then a positive argument demonstrates why the medical (...) profession requires its own distinctive ethics. The paper also provides a way to distinguish roles and professions and an account of the distinctive duties of medical ethics. It concludes by emphasizing ways in which the uncommon morality approach to medical ethics is markedly different from the common morality approach. (shrink)

Rhodes seeks to defend her ‘conclusion that everyday ethics and medical ethics [are] incompatible’.1 She challenges ‘views that medical ethics is nothing more than common morality applied to clinical matters’ (Rhodes, p2).1 Beauchamp and Childress explicate the term ‘common morality’ at length.2 Nowhere do they claim that medical ethics is ‘nothing more than common morality applied to clinical matters’. Here is what they do say: “The origin of the norms of the common morality is no different in principle from the (...) origin of the norms of a particular morality for a medical or other profession … The primary difference is that the common morality has authority in all communities, whereas particular moralities are authoritative only for specific groups” (Beauchamp and Childress, p8).2 This critique discusses the seven examples Rhodes uses to illustrate her main point: that common morality and medical ethics are radically different. I contend that common morality accounts for the purported differences she cites. In ordinary life, people can simply mind their own business, whereas physicians have a duty to act in their professional setting. On this view, common morality cannot explain the moral obligation people have to prevent easily avoidable harm to others. A bystander …. (shrink)

​Rosamond Rhodes contends, by reference to seven examples, that medical ethics is distinctly different from non-medical ethics. Each of those examples, on proper examination, illustrates precisely the opposite contention. It is clear not only that medical ethics relies on the same principles as non-medical (and indeed non-professional) ethics, but that it should so rely. A distinctively medical ethics would be dangerous: it would divorce ethical medical decision-making from the patients whom medicine exists to serve.