Abstract
This paper is about the methodology of doing practical ethics. There is a variety of methods employed in ethics. One of them is the principle-based approach, which has an established place in ethical reasoning. In everyday life, we often judge the rightness and wrongness of actions by their conformity to principles, and the appeal to principles plays a significant role in practical ethics, too. In this paper, I try to provide a better understanding of the nature of principle-based reasoning. To accomplish this, I show in the first section that these principles can be applied to cases in a meaningful and sufficiently precise way. The second section discusses the question how relevant applying principles is to the resolution of ethical issues. This depends on their nature. I argue that the principles under consideration in this paper should be interpreted as presumptive principles and I conclude that although they cannot be expected to bear the weight of definitely resolving ethical problems, these principles can nevertheless play a considerable role in ethical research.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
Among the proposed ways of doing ethics are the case-based method (which uses case comparison and analogy to reach ethical conclusions), narrative ethics (which emphasizes the particularities of an ethical issue as they are articulated in personal narratives), the virtue ethics approach (which focuses on the character of agents rather than on the rightness of their conduct), and the principle-based method, according to which the resolution of an ethical issue requires bringing the relevant facts under a general principle.
The principles are, however, based on an ethical tradition, which serves as a warrant for them. For example, the harm principle has a utilitarian background and the principles of double effect as well as the principles of ordinary and extraordinary treatment have been developed on a Christian background.
A recent version of the precautionary principle states: “When human activities may lead to morally unacceptable harm that is scientifically plausible but uncertain, actions shall be taken to avoid or diminish that harm” [24]. The principle expresses the idea that the main burden of providing evidence for safety rests on those who propose a new technique or activity. The principle has been widely applied in contexts which now extend far beyond its origins in environmental regulation.
Mill’s harm principle states that “the only purpose for which power can be rightfully exercised over any member of a civilized community against his will, is to prevent harm on others” [Mill (1978). On liberty (ed. by E. Rapaport). Indianapolis: Hackett, p. 9]. The principle applies to problems of personal liberty and its limits. It has been applied to a variety of ethical issues; for instance, to surrogate motherhood [10], pornography [8], or the justification of indoor smoking bans [17].
According to a traditional version of the principle of double effect, an act that has both a good and a bad effect is permissible if the act is not bad in itself, the agent intends as an end only the good effect, the agent does not intend the bad effect as a means to the good, and the good effect is at least equivalent in importance to the bad effect (see [21]). The principle has been used to find out whether an act that has both good and bad effects is permissible. It has a long history in Catholic moral thinking and has played a significant role in the discussion of many difficult ethical problems. Its most prominent application, however, is in medical ethics, where it represents an analytical tool for resolving complex ethical problems confronted by health care professionals in a variety of contexts. It has been used to find out whether an act that has both good and bad effects is permissible.
According to the principles of ordinary and extraordinary treatment, the use of ordinary means of treatment is morally obligatory, while the use of extraordinary means of treatment is morally optional (see [20]). The principles are a guide for decision-making in medical ethics where they play a role in the ongoing debate about euthanasia and in decision-making on severely handicapped infants (e.g., cases of anencephaly), the right of the elderly to refuse aggressive life-extending treatment, end-of-life care of patients in a persistent vegetative state, and other life-and-death issues.
It should be noted that there exist different versions of these principles. But since I take them here for illustrative purposes only, we can ignore these differences.
In this paper, I focus on the normative (or deontic) status of actions. But principles can also assign things (motives, traits of character, people) axiological properties (by asserting that they are good or bad) or an aretaic status (by stating that they are virtuous or vicious).
Specification is one approach to solve the problem of indeterminacy. It attempts to formulate more specific principles that are exactly tailored to fit the details of certain situations (see [4, 96–97]; [13]). Be it noted that specification is different from defining key terms of a principle. If one defines ‘morally unacceptable harm’ in the precautionary principle, one needs to make clear what this term means. But specifying the principle requires making the principle more concrete by adding further clauses to it (e.g., that it is currently impossible to reduce the uncertainties). Specification has, however, serious shortcomings. For example, not all principles seem to be amenable to specification and the process of specification seems to be arbitrary (see [5]).
It seems, however, that neither the absolutist account nor the prima facie view can give a satisfactory account of principles such as ‘promises ought to be kept’. For example, if a promise is such that one ought not to have given it or that it was given under duress, particularist ethicists (e.g., [6]) have claimed that the fact that one has promised to do something does not favour doing it. Particularists, therefore, hold that such principles should be understood as presumptive principles (see below).
There is a terminological confusion in the literature. Some use the term ‘presumptive principle’ for prima facie principles (e.g., [5]) and others call them (or something very similar) default principles [22]. I have dubbed them presumptive principles because this term seems to me the most appropriate one.
It is noteworthy that the claim is not that there are always defeating factors but only that there could be other factors than a principle’s condition of application that would have an impact on the normative status of an action.
For example, the version of the precautionary principle that I have used in this paper was developed by a group of experts that have been commissioned by the UN (see [24]).
In recent years, the principle of double effect has been repeatedly applied by the magisterium of the Catholic Church (see, for instance, the Declaration by the Pontificate Council for the Family regarding “Embryonic Reduction” < www.vatican.va/roman_curia/pontifical_councils/family/documents >. On the use of the principle of ordinary treatment, see, for instance: Sacred Congregation for the Doctrine of the Faith (1980). Declaration on Euthanasia. 72 Acta Apostolicae Sedis 542–552.
References
Alexy, R. (2003). On balancing and subsumption. A structural comparison. Ratio Juris, 16(4), 433–499.
Arras, J. (2010). Theory and bioethics. In E. N. Zalta (Ed.), The stanford encyclopedia of philosophy. <http://plato.stanford.edu/archives/sum2013/entries/theory-bioethics/>.
Bayles, M. D. (1976). Harm to the unconceived. Philosophy and Public Affairs, 5(3), 292–304.
Beauchamp, T. L., & Childress, J. F. (2009). Principles of biomedical ethics (6th ed.). New York: Oxford University Press.
Childress, J. F. (2007). Methods in bioethics. In B. Steinbock (Ed.), The Oxford handbook of bioethics (pp. 15–45). Oxford: Oxford University Press.
Dancy, J. (2013). Moral Particularism. In E. N. Zalta (Ed.), The Stanford encyclopedia of philosophy. <http://plato.stanford.edu/archives/fall2013/entries/moral-particularism/>.
De Bruin, B. (2014). Alcohol in the media and young people: What do we need for liberal policy-making? Public Health Ethics, 7(1), 35–46.
Dyzenhaus, D. (1992). John Stuart Mill and the harm of pornography. Ethics, 102(3), 534–551.
Hoffmaster, B., & Hooker, C. (2009). How experience confronts ethics. Bioethics, 23(4), 214–225.
Holtug, N. (2002). The harm principle. Ethical Theory and Moral Practice, 5(4), 357–389.
Kelly, G. (1951). The duty to preserve life. Theological Studies, 12, 550–556.
Raz, J. (1999). Practical reason and norms. Oxford: Oxford University Press.
Richardson, H. S. (1990). Specifying norms as a way to resolve concrete ethical problems. Philosophy and Public Affairs, 19(4), 279–310.
Ross, W. D. (1930). The right and the good. Oxford: Clarendon.
Sandin, P. (1999). Dimensions of the precautionary principle. Human and Ecological Risk Assessment, 5(5), 889–907.
Shafer-Landau, R. (1997). Moral rules. Ethics, 107(4), 584–611.
Silva, D. S. (2011). Smoking bans and persons with schizophrenia: A straightforward use of the harm principle? Public Health Ethics, 4(2), 143–148.
Singer, P. (2003). Voluntary euthanasia: A utilitarian perspective. Bioethics, 17(5–6), 526–541.
Smith, K. (2013). Synthetic biology: A utilitarian perspective. Bioethics, 27(8), 453–463.
Spielthenner, G. (2007). Ordinary and extraordinary means of treatment. Ethics & Medicine: An International Journal of Bioethics, 23(3), 145–158.
Spielthenner, G. (2008). The principle of double effect as a guide for medical decision-making. Medicine, Healthcare and Philosophy, 11(4), 465–473.
Stangl, R. L. (2006). Particularism and the point of moral principles. Ethical Theory and Moral Practice, 9(2), 201–229.
Toulmin, S. (1981). The tyranny of principles. The Hastings Center Report, 11(6), 31–39.
UNESCO. (2005). The precautionary principle: World commission on the ethics of scientific knowledge and technology (COMEST). Paris: Unesco.
Vandevelde, K. J. (2011). Thinking like a lawyer: An introduction to legal reasoning (2nd ed.). Boulder: Westview Press.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Spielthenner, G. The Principle-Based Method of Practical Ethics. Health Care Anal 25, 275–289 (2017). https://doi.org/10.1007/s10728-015-0295-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10728-015-0295-x