A Critique of Principlism

TLDR

Principlism refers to using principles to replace moral theory and rules in medical ethics, but these principles are merely labels for loosely related considerations rather than actionable guides. The authors argue that these principles fail to function as claimed and are misleading both practically and theoretically. They contrast principlism with a unified moral theory, outlining the advantages of the latter. The principles lack systematic relationships, often conflict, and these conflicts are unresolvable due to the absence of a unified moral theory.

Abstract

The authors use the term "principlism" to refer to the practice of using "principles" to replace both moral theory and particular moral rules and ideals in dealing with the moral problems that arise in medical practice. The authors argue that these "principles" do not function as claimed, and that their use is misleading both practically and theoretically. The "principles" are in fact not guides to action, but rather they are merely names for a collection of sometimes superficially related matters for consideration when dealing with a moral problem. The "principles" lack any systematic relationship to each other, and they often conflict with each other. These conflicts are unresolvable, since there is no unified moral theory from which they are all derived. For comparison the authors sketch the advantages of using a unified moral theory.