A Critique of Principlism

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.

Challenging the Moral Status of Blood Donation

“…One perceived strength of the principles is that they can be derived from any of the major moral theories. This theoretical hedging is also a source of critique from Clouser and Gert (1990) who argue that the theoretical source of the principle of beneficence is Mill and utilitarianism. An act of beneficence is an act that helps others, but Beauchamp and Childress (2008) are clear that not all acts of beneficence are obligatory and though they take care to root their system in common morality, its purpose is to guide action within the special relationships that healthcare professionals have with those in their care.…”

Críticas ao principialismo em bioética: perspectivas desde o norte e desde o sul

“…Por outro lado, diversos autores já lançaram críticas contra essa corrente de pensamento da bioética Gert, 1990;Holm, 1995;Culver;Clouser, 1997;Schramm;Kottow, 2001;Garrafa;Porto, 2003;Garrafa, 2005;Tealdi, 2006;Garrafa;Azambuja, 2007;Tealdi, 2008) utilizando como objeto críticas de diferentes aspectos e origens. A própria expressão "principialismo" nasce no contexto crítico a essa perspectiva bioética Gert, 1990).…”

“…A própria expressão "principialismo" nasce no contexto crítico a essa perspectiva bioética Gert, 1990). O presente artigo visa, justamente, sistematizar as principais críticas relacionadas à bioética principialista e, por entender que existem diferenças significativas entre os pontos de crítica apresentados, também se propõe a separar essas críticas em dois grupos: críticas vindas desde o Hemisfério Norte (ou críticas norteadas) e críticas desde o Hemisfério Sul (ou críticas suleadas).…”

Sanitary justice in scarcity

“…Critics of principalism are especially punctilious with regard to justice (Clouser & Gert, 1990), to the point of stating that "We suspect that even the proponents of principalism do not put much stock in the principle of justice as an action guide. The principle of justice seems to be a prime example of a principle functioning simply as a checklist of moral concerns" (Clouser, 1995:225).…”