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date: 27 June 2019

Abstract and Keywords

This chapter explains and defends the theory and methods of principlism as a theoretical approach to biomedical ethics. Principlism is not merely a framework of four principles; it is a method for using these principles in practice. I discuss their practical roles in biomedical ethics, with a focus on psychiatric ethics. I start with a history of the use of principles in bioethics and then turn to the nature and commitments of the framework of four clusters of principles that James Childress and I defend. Also analyzed is the central place occupied in principlism by common morality theory—the theory that basic moral standards apply everywhere in the moral life across all cultures. Particular moralities, such as those found in professional ethics guidelines, are shown to presuppose universally valid principles. Finally, I explain the central role of specification—the method by which general principles are made concrete and practical.

Keywords: principlism, four-principles approach, respect for autonomy, nonmaleficence, beneficence, justice, balancing, specification, psychiatric ethics

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