Principles that provide general normative frameworks in bioethics have been criticized since the late 1980s, when several different methods and types of moral philosophy began to be proposed as alternatives or substitutes. Several accounts have emerged in recent years, including: (1) Impartial Rule Theory (supported in this issue by K. Danner Clouser), (2) Casuistry (supported in this issue by Albert Jonsen), and (3) Virtue Ethics (supported in this issue by Edmund D. Pellegrino). Although often presented as rival methods or theories, (...) these approaches are consistent with and should not be considered adversaries of a principle-based account. (shrink)

While much attention has been given to the use of principles in biomedical ethics and increasing attention is given to alternative theoretical approaches, relatively little attention has been devoted to the critical task of how one resolves conflicts among competing principles. After summarizing the system of principles and some problems in conceptualizing the principles, several strategies for reconciling conflicts among principles are examined including the use of single-principle theories (pure libertarianism, pure utilitarianism, and pure Hippocratism), balancing theories, conflicting appeals theories, (...) and lexical ordering. Then a mixed strategy is proposed in which consequentialist principles are balanced between themselves as are nonconsequentialist principles, after which the result of balancing the nonconsequentialist principles is lexically ranked over the result of balancing the consequentialist ones. Finally, strategies involving specifying and rule generation are discussed concluding that most current specification and rule-generating theories must involve some degree of lexical ordering of principles. (shrink)

Two years ago in two articles in a thematic issue of this journal the three of us engaged in a critique of principlism. In a subsequent issue, B. Andrew Lustig defended aspects of principlism we had criticized and argued against our own account of morality. Our reply to Lustig's critique is also in two parts, corresponding with his own. Our first part shows how Lustig's criticisms are seriously misdirected. Our second and philosophically more important part picks up on Lustig's challenge (...) to us to show that our account of morality is more adequate than principlism. In particular we show that recognition of morality as public and systematic enables us to provide a far better description of morality than does principlism. This explains why we adopt the label “Dartmouth Descriptivism.”. (shrink)

Selim Berker argues that particularists do not have a coherent notion of reasons for action because they cannot show that contributory reasons always contribute to overall reason or moral judgments in accordance with their valence. I argue that Berker fails to demonstrate that particularists cannot show this to be the case. He also wrongly assumes that they need to know this to be the case to legitimately speak of reasons for action. Furthermore, Jonathan Dancy’s account of practical reasoning explains how (...) particularists can legitimately speak of reasons for action while claiming that reasons sometimes make contributions contrary to their valence. (shrink)

One of the reasons why most of us feel puzzled about the problem of abortion is that we want, and do not want, to allow to the unborn child the rights that belong to adults and children. When we think of a baby about to be born it seems absurd to think that the next few minutes or even hours could make so radical a difference to its status; yet as we go back in the life of the fetus we (...) are more and more reluctant to say that this is a human being and must be treated as such. No doubt this is the deepest source of our dilemma, but it is not the only one. For we are also confused about the general question of what we may and may not do where the interests of human beings conflict. We have strong intuitions about certain cases; saying, for instance, that it is all right to raise the level of education in our country, though statistics allow us to predict that a rise in the suicide rate will follow, while it is not all right to kill the feeble-minded to aid cancer research. It is not easy, however, to see the principles involved, and one way of throwing light on the abortion issue will be by setting up parallels involving adults or children once born. So we will be able to isolate the “equal rights” issue and should be able to make some advance... (shrink)

‘Applied ethics’, as that expression is now used, is a single rubric for a large range of different theoretical and practical activities. Such rubrics function partly as a protective device both within the academic community and outside it; a name of this kind suggests not just a discipline, but a particular type of discipline. In the case of ‘applied ethics’ the suggestive power of the name derives from a particular conception of the relationship of ethics to what goes on under (...) the rubric of ‘applied ethics’. Not everyone who conducts activities under that rubric owes allegiance to this conception and there are doubtless some who would repudiate it as strongly as I do. But it is that dominant conception from which most work in this area derives or aspires to derive its philosophical legitimacy. What is that conception? (shrink)

In this essay I offer a new particularist reading of Aristotle’s Nicomachean Ethics. I argue that the interpretation I present not only helps us to resolve some puzzles about Aristotle’s goals and methods, but it also gives rise to a novel account of morality—an account that is both interesting and plausible in its own right. The goal of this paper is, in part, exegetical—that is, to figure out how to best understand the text of the Nicomachean Ethics. But this paper (...) also aims to contribute to the current exciting and controversial debate over particularism. By taking the first steps towards a comprehensive particularist reading of Aristotle’s Ethics I hope to demonstrate that some of the mistrust of particularism is misplaces and that what is, perhaps, the most influential moral theory in the history of philosophy is, arguably, a particularist moral theory. (shrink)

The author presents and defends three theses: (1) "the first is that it is not profitable for us at present to do moral philosophy; that should be laid aside at any rate until we have an adequate philosophy of psychology." (2) "the second is that the concepts of obligation, And duty... And of what is morally right and wrong, And of the moral sense of 'ought', Ought to be jettisoned if this is psychologically possible...." (3) "the third thesis is that (...) the differences between the well-Known english writers on moral philosophy from sidgwick to the present day are of little importance." (staff). (shrink)

Clouser and Gert’s 'A Critique of Principlism’ (1990) has ignited debate over the adequacy of substituting principlism for moral theory as a means for dealing with biomedical dilemmas. Clouser and Gert argue that this sort of substitution is not adequate to the task. I examine their argument in light of recent defences of principlism on this score, those of B. Andrew Lustig (1992), David Degrazia (1992), and Beauchamp and Childress (1994). I argue that both sides in the debate have assumed (...) differing conceptions of a moral theory that virtually guarantee their respective conclusions. These differing conceptions are motivated by antecedent epistemological commitments. The present debate over principlism is therefore inconclusive. Future discussion should focus on the underlying epistemological issues. (shrink)

In this commentary, I critically discuss the respective views of Gert and Beauchamp–Childress on the nature of so-called common morality and its promise for enriching ethical reflection within the field of bioethics. Although I endorse Beauchamp and Childress’ shift from an emphasis on ethical theory as the source of moral norms to an emphasis on common morality, I question whether rouging up common morality to make it look like some sort of ultimate and universal foundation for morality, untouched by the (...) dialectics of time and reflective equilibrium, was an equally good move. As for Gert’s magisterial conception of common morality, I conclude that certain elements of his system are controversial at best and woefully inadequate at worst. He has a tendency to find in common morality what he himself put there, and his highly restricted conception of duties of assistance strikes this reader as ad hoc, inadequately defended, and unworthy of a project whose goal is to lessen the amount of misery in the world. (shrink)

In this much-anticipated book, Jonathan Dancy offers the only available full-scale treatment of particularism in ethics, a view with which he has been associated for twenty years. Dancy now presents particularism as the view that the possibility of moral thought and judgement does not in any way depend on an adequate supply of principles. He grounds this claim on a form of reasons-holism, holding that what is a reason in one case need not be any reason in another, and maintaining (...) that moral reasons are no different in this respect from others. Ethics Without Principles offers detailed treatment and criticism of opposing positions of all sorts, with useful summaries. It also contains three chapters on the nature of what Dancy calls 'contributory' reasons, which, though the topic of much interest at the moment, are not often discussed in anything like the detail given here. And it offers a distinctive form of value-holism to go with the holism of reasons. As Dancy's definitive statement on particularism, the book will be required reading for all those working on moral philosophy and ethical theory. (shrink)

Moral particularism is a contentious position at present and seems likely to be so for the foreseeable future. In this Introduction, I outline and detail its essential claim, which I take to be, roughly, that what can be a reason that helps to make one action right need not be a reason that always helps to make actions right. This claim challenges a central assumption on which most, if not all, normative ethical theories are supposedly based. We owe this way (...) of characterizing moral particularism to Jonathan Dancy, around whose writings much of the present debate revolves. Key Words: ethics • generalism • particularism • reasons • valency. (shrink)

This paper is a discussion of Jonathan Dancy's book Ethics Without Principles (2004). Holism about reasons is distinguished into a weak version, which allows for invariant reasons, and a strong, which doesn't. Four problems with Dancy's arguments for strong holism are identified. (1) A plausible particularism based on it will be close to generalism. (2) Dancy rests his case on common-sense morality, without justifying it. (3) His examples are of non-ultimate reasons. (4) There are certain universal principles it is hard (...) not to see as invariant, such as that the fact that some action causes of suffering to a non-rational being always counts against it. The main difficulty with weak holism is that justification can be seen as analogous to explanation, which will give us an atomistic and generalist conception of a normative reason. Key Words: Dancy • generalism • holism • particularism • reasons. (shrink)

In this paper I argue for a particularist understanding of thick evaluative features, something that is rarely done and is fairly controversial. That is, I argue that sometimes that the fact that an act is just, say, could, in certain situations, provide one with a reason against performing the action. Similarly, selfishness could be right-making. To show this, I take on anti-particularist ideas from two much-cited pieces (by Crisp, and by McNaughton and Rawling), in the influential Moral Particularism anthology (eds.) (...) Hooker and Little (OUP). My paper has already been cited by other people working in the field. (shrink)

AbstractThe Belmont Report continues to be held in high regard, and most bioethical analyses conducted in recent years have presumed that it affects United States federal regulations. However, the assessments of the report’s creators are sharply divided. Understanding the historic reputation of this monumental report is thus crucial. We first recount the historical context surrounding the creation of this report. Subsequently, we review the process involved in developing ethical guidelines and describe the report’s features. Additionally, we analyze the effect of (...) unfolding events on the subsequent creation of federal regulations, especially on gene therapy clinical trials. Moreover, throughout this paper we evaluate the ethical principles outlined in this report and describe how they overlap with the issue of protecting socially vulnerable groups. Based on the analysis, we conclude that the features of the Belmont Report cannot be considered as having affected the basic sections of the federal regulations for ethical reviews that were made uniform in 1981. Nevertheless, regarding the regulations on gene therapy clinical trials—which were at first expected to be applicable to research involving children—in addition to implementing policies regarding the public review of protocols that passed ethical review, this report’s principles are clearly reflected in the key notes that should have been referred to when the report was created. (shrink)

Previous edition, 1st, published in 1971.

The Belmont Report of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was essentially mandated in a public law on July 12, 1974. The publications of this Commission have turned out to be the most influential of all US ethics and bioethics commissions on US public policy and federal regulation. The reason for its influence is that this Commission was allowed—indeed required—to draft federal regulations governing research with vulnerable subjects and to produce a general (...) framework of moral principles that quickly became established as the only framework of general principles of research ethics for the government of the United States.The public law mandated that the... (shrink)

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. (shrink)

Volume 19, Issue 11, November 2019, Page 9-12.

: The fifth edition of Beauchamp and Childress's Principles of Biomedical Ethics is distinguished by its emphatic embrace of common morality as the ultimate source of moral norms. This essay critically evaluates the fifth edition's discussion of common morality and, to a lesser extent, its treatment of coherence (both the model of ethical justification and the associated concept). It is argued that the book is overly accommodating of existing moral beliefs. The paper concludes with three suggestions for improving this leading (...) text. (shrink)

Given intractable moral pluralism, what ought one to make of the bioethics that arose in the early 1970s, grounded as it was in the false assumption that there is a common secular morality that secular bioethics ought to apply? It is as if bioethics developed without recognition of the crisis at the heart of secular morality itself. Secular moral rationality cannot of itself provide the foundations to identify a particular morality and its bioethics as canonical. One is not just confronted (...) with intractable moral and bioethical pluralism, but with the absence of a secular ground that can show why one should act morally rather than self-interestedly. The result is not merely the deflation of much of traditional Western morality to life-style and death-style choices, but the threat of deflating to political slogans the now-dominant secular morality, including its affirmation of human autonomy, equality, social justice, and human dignity. All of this invites one critically to reconsider the meaning and force of secular bioethics. (shrink)

For decades now, moral philosophy and bioethics have been dominated variously by universalist and particularist impulses, both of which exert legitimate pull on our thinking. Although there is little prospect of settling the debate by recourse to theory, classifying the cases in which particularist and universalist demands compete reveals a rough practical guide.

As suggested by David E. Boeyink, casuistry is a promising method for making ethical decisions in journalism because its “case-oriented strategy fits [the] general approach” of many journalists while its stress on consistency guards against arbitrariness. Despite its emphasis on consistency, however, casuistry gives self-interested decision makers enough wiggle room to rationalize whatever is expedient. For this reason, casuistry relies also on character. Yet writers who have studied casuistry have said relatively little about the link between character and casuistry and, (...) when they have, they have focused on the intellectual virtue of phronesis. This article articulates the essential moral virtues necessary to prevent arbitrariness in casuistry when practiced by journalists and demonstrates their relevance in relation to a recent case in which the journalist’s character was a key factor. The article concludes with several strategies for nurturing good character among journalists. (shrink)

The four principles approach to medical ethics plus specification is used in this paper. Specification is defined as a process of reducing the indeterminateness of general norms to give them increased action guiding capacity, while retaining the moral commitments in the original norm. Since questions of method are central to the symposium, the paper begins with four observations about method in moral reasoning and case analysis. Three of the four scenarios are dealt with. It is concluded in the “standard” Jehovah’s (...) Witness case that having autonomously chosen the authority of his religious institution, a Jehovah’s Witness has a reasonable basis on which to refuse a recommended blood transfusion. The author’s view of the child of a Jehovah’s Witness scenario is that it is morally required—not merely permitted—to overrule this parental refusal of treatment. It is argued in the selling kidneys for transplantation scenario that a fair system of regulating and monitoring would be better than the present system which the author believes to be a shameful failure. (shrink)

The field of bioethics has deployed different models of justification for particular moral judgments. The best known models are those of deductivism, casuistry, and principlism (under one, rather limited interpretation). Each of these models, however, has significant difficulties that are explored in this essay. An alternative model, suggested by the work of Henry Richardson, is presented. It is argued that specified principlism is the most promising model of justification in bioethics. Keywords: casuistry, deductivism, ethical theories, intuition principlism, specified principlism, specification (...) CiteULike Connotea Del.icio.us What's this? (shrink)

The four-principle approach to biomedical ethics is used worldwide by practitioners and researchers alike but it is rather unclear what exactly people do when they apply this approach. Ranking, specification, and balancing vary greatly among different people regarding a particular case. Thus, a sound and coherent applicability of principlism seems somewhat mysterious. What are principlists doing? The article examines the methodological strengths and weaknesses of the applicability of this approach. The most important result is that a sound and comprehensible application (...) of the four principles is additionally ensured by making use of the organizing meta-principle of common morality, which is the starting point and constraining framework of moral reasoning. (shrink)

: A comparison of casuistry with the strain of particularism developed by John McDowell and David Wiggins suggests that casuistry is susceptible to two very different mistakes. First, as sometimes developed, casuistry tends toward an implausible rigidity and systematization of moral knowledge. Particularism offers a corrective to this error. Second, however, casuistry tends sometimes to present moral knowledge as insufficiently systematized: It often appears to hold that moral deliberation is merely a kind of perception. Such a perceptual model of deliberation (...) cannot offer a convincing account of the possibility of moral progress. This second problem is one to which particularism is itself prone. To redress it, other aspects of casuistry must be exploited: Casuistry contains an account of presumptive generalizations that explains how moral deliberation might be structured by rules while also depending at critical junctures on perception. (shrink)

After briefly sketching common-morality principlism, as presented in Principles of Biomedical Ethics, this paper responds to two recent sets of challenges to this framework. The first challenge claims that medical ethics is autonomous and unique and thus not a form of, or justified or guided by, a common morality or by any external morality or moral theory. The second challenge denies that there is a common morality and insists that futile efforts to develop common-morality approaches to bioethics limit diversity and (...) prevent needed moral change. This paper argues that these two critiques fundamentally fail because they significantly misunderstand their target and because their proposed alternatives have major deficiencies and encounter insurmountable problems. (shrink)

In celebration of the fortieth anniversary of the publication of Beauchamp and Childress’s Principles of Biomedical Ethics, a review is undertaken to compare the lists of principles in various bioethical theories to determine the extent to which the various lists can be reconciled. Included are the single principle theories of utilitarianism, libertarianism, Hippocratism, and the theories of Pellegrino, Engelhardt, The Belmont Report, Beauchamp and Childress, Ross, Veatch, and Gert. We find theories all offering lists of principles numbering from one to (...) ten. Many of the differences can be reconciled, but some critical differences remain. (shrink)

Book reviewed in this article: For the Patient's Good: The Restoration of Beneficence in Health Care. By Edmund D. Pellegrino and David C. Thomasma.

The main claim of this paper is that the method outlined and used in Aristotle’s Ethics is an appropriate and credible one to use in bioethics. Here “appropriate” means that the method is capable of establishing claims and developing concepts in bioethics and “credible” that the method has some plausibility, it is not open to obvious and immediate objection. It begins by suggesting why this claim matters and then gives a brief outline of Aristotle’s method. The main argument is made (...) in three stages. First, it is argued that Aristotelian method is credible because it compares favourably with alternatives. In this section it is shown that Aristotelian method is not vulnerable to criticisms that are made both of methods that give a primary place to moral theory (such as utilitarianism) and those that eschew moral theory (such as casuistry and social science approaches). As such, it compares favourably with these other approaches that are vulnerable to at least some of these criticisms. Second, the appropriateness of Aristotelian method is indicated through outlining how it would deal with a particular case. Finally, it is argued that the success of Aristotle’s philosophy is suggestive of both the credibility and appropriateness of his method. (shrink)

: Bernard Gert's theory of morality has received much critical attention, but there has been relatively little commentary on its practical value for bioethics. An important test of an ethical theory is its ability to yield results that are helpful and plausible when applied to real cases. An examination of Gert's theory and his own attempts to apply it to bioethics cases reveals that there are serious difficulties with regard to its application. These problems are sufficiently severe to support the (...) conclusion that Gert's theory is unacceptable as an approach for resolving bioethics cases, even relatively noncontroversial cases. (shrink)

Casuistry is a traditional method of interpreting and resolving moral problems. It focuses on the circumstances of particular cases rather than on the application of ethical theories and principles. After a brief history of casuistry, the method is explained and its relation to theory and principles is discussed.

Bioethicists’ attraction to principlism is rooted in a Western view of how matters that affect the public ought to be deliberated and decided: their resolution ought to be so structured and constrained that it can be understood and verified even by those at a remove from the circumstances of the problem. That view of deliberation, itself fostered by the Western view of government, has encouraged principlism to spread from its source in human subjects research into other areas of bioethics discourse.