title: The method of 'principlism': a critique of the critique.
abstract: Several scholars have recently criticized the dominant emphasis upon mid-level principles in bioethics best exemplified by Beauchamp and Childress's Principles of Biomedical Ethics. In Part I of this essay, I assess the fairness and cogency of three broad criticisms raised against 'principlism' as an approach: (1) that principlism, as an exercise in applied ethics, is insufficiently attentive to the dialectical relations between ethical theory and mortal practice; (2) that principlism fails to offer a systematic account of the principles of non-maleficence, beneficence, respect for autonomy, and justice; and (3) that principlism, as a version of moral pluralism, is fatally flawed by its theoretical agnosticism. While acknowledging that Beauchamp and Childress's reliance upon Ross's version of intuitionism is problematic, I conclude that the critics of principlism have failed to make a compelling case against its theoretical or practical adequacy as an ethical approach. In Part II, I assess the moral theory developed by Bernard Gert in Mortality: A New Justification of the Moral Rules, because Gert has recommended his approach as a systematic alternative to principlism. I judge Gert's theory to be seriously incomplete and, in contrast to principlism, unable to generate coherent conclusions about cases of active euthanasia and paternalism.
authors.affiliation: Institute of Religion, Texas Medical Center, Houston.
authors.forename: B A
authors.initials: BA
authors.lastname: Lustig
mesh_terms: D026686:Beneficence; D032764:Casuistry; D026689:Ethical Analysis; D028663:Ethical Theory; D026822:Ethicists; D004992:Ethics, Medical; D005065:Euthanasia; D028601:Euthanasia, Active; D006801:Humans; D028681:Moral Obligations; D009014:Morals; D026706:Paternalism; D026684:Personal Autonomy; D010686:Philosophy, Medical; D010817:Physician-Patient Relations; D028662:Principle-Based Ethics; D012945:Social Values