Encyclopedia of Global Bioethics

2016 Edition
| Editors: Henk ten Have


Reference work entry
DOI: https://doi.org/10.1007/978-3-319-09483-0_348


The term “principlism” designates an approach to biomedical ethics that uses a framework of four universal and basic ethical principles: respect for autonomy, nonmaleficence, beneficence, and justice. It is presented and defended in Beauchamp and Childress’ Principles of Biomedical Ethics. The basic principles state prima facie (or non-absolute) moral obligations that are rendered practical by being specified for particular contexts. Moral problems arise when principles or their specifications come into conflict with each other. The conflicts are resolved by further specification or balancing judgments. Principlism justifies moral reasoning by appealing to the method of reflective equilibrium and to the common morality. Principlism is committed to a global bioethics because the principles are universally applicable, not merely local, customary, or cultural rules. They are correlative to basic human rights and set limits to what is ethically acceptable in all societies, but they are also sensitive to particular conditions in societies and cultures that may account for legitimate differences in the ethics of medical research and practice.


Coherence theory Common morality Human rights Principles of bioethics Principlism Reflective equilibrium Specification 
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  1. Beauchamp, T. L., & Childress, J. F. (2013). Principles of biomedical ethics (7th ed.). New York: Oxford University Press.Google Scholar
  2. Clouser, K. D., & Gert, B. (1990). A critique of principlism. Journal of Medicine and Philosophy, 15, 219–236.Google Scholar
  3. Daniels, N. (1996). Wide reflective equilibrium in practice. In L. W. Sumner & J. Boyle (Eds.), Philosophical perspectives on bioethics. Toronto, ON: University of Toronto Press.Google Scholar
  4. Gillon, R. (1993). Principles of health care ethics. Hoboken: Wiley-Blackwell.Google Scholar
  5. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of research. Federal Register.Google Scholar
  6. Rawls J. (1999/1971). A theory of justice. Cambridge, MA: Harvard University Press.Google Scholar
  7. Rendtorff, J. D. (2002). Basic ethical principles in European bioethics and biolaw: autonomy, dignity, integrity and vulnerability – Towards a foundation of bioethics and biolaw. Medicine, Healthcare and Philosophy, 5, 235–244.Google Scholar
  8. Richardson, H. J. (1990). Specifying norms as a way to resolve concrete ethical problems. Philosophy and Public Affairs, 19, 279–310.Google Scholar
  9. Richardson, H. J. (2000). Specifying, balancing, and interpreting bioethical principles. Journal of Medicine and Philosophy, 25, 285–307.Google Scholar
  10. Ross, W. D. (1988/1930). The right and the good. Oxford: Clarendon Press. Reprinted Indianapolis, IN: Hackett.Google Scholar
  11. Trials of war criminals before the Nuernberg military tribunals under control council law no 10. Military Tribunal I. (1948–49). Washington, DC: U.S. Government Printing Office.Google Scholar
  12. World Medical Association. (2008). Declaration of Helsinki. Available online: http://www.wma.net/en/20activities/10ethics/10helsinki/index.html. Accessed 29 Jan 2015.

Further Readings

  1. Beauchamp, T. L. (2010). Standing on principles: collected essays. New York: Oxford University Press.Google Scholar
  2. Beauchamp, T. L., & Childress, J. F. (2013). Principles of biomedical ethics (7th ed.). New York: Oxford University Press.Google Scholar
  3. Gillon, R. (2003). Ethics needs principles – Four can encompass the rest–and respect for autonomy should be ‘first among equals’. Journal of Medical Ethics, 29, 307–312.Google Scholar
  4. Rauprich, O. (2008). Common morality: Comment on Beauchamp and Childress. Theoretical Medicine and Bioethics, 29, 43–71.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Philosophy Department and Kennedy Institute of EthicsGeorgetown UniversityWashingtonUSA
  2. 2.Institute for Ethics, History, and Theory of MedicineLudwig-Maximilian-University MunichMunichGermany