In Defense of Four Principles Approach in Medical Ethics

Abstract

Principlism, in general and Four Principles Approach in particular is largely discussed in current medical ethics. Accord­ing to principlism, the ethical relationship between physician and patient has to be categorized based on some princi­ples, the prin­ciples which are general, action-guiding and could help both the patient and the physician to arrange their ethical behav­ior. Four Principles Approach which is a principlistic view, has formulated the princi­ples which have to be considered in medi­cal ethics in the light of Rossian ethical framework as follows: respect for auton­omy, nonmalefi­cience, beneficence and jus­tice. Ethical Particularism, on the other hand, strongly criticizes princi­plism and repudi­ates the very idea of generalizabil­ity in the realm of ethics. According to particularists, the way in which a mor­ally relevant feature like fidelity and justice be­have in different ethical occasions is fully con­text-dependent so that they can­not be patternable in advance. It follows from this that fidelity, for instance, is not a good-making feature, generally speak­ing.
In this paper, firstly, the Rossian ethics is discussed in order to make Four Principles Approach intelligible. Sec­ondly, the main particularists' argument against principlism is formulated. Finally, Particularists' argument is evalu­ated and its plau­si­bility is discussed.