Principlism in bioethics: features and possible limitations




bioethics, medical ethics, moral theories, principlism, principles of bioethics, rules of bioethics


Advantages and disadvantages of one of the most influential methodological approaches in bioethics – principlism – are considered. The practical origins of principlism in bioethics and its theoretical origins in the philosophy of principles are revealed. The main philosophical sources of bioethics are indicated, which include utilitarianism, Kantian ethics, rule-based theory of general morality, virtue ethics, and feminist ethics. The irreducibility of principlism to any of these theories in particular and at the same time its appeal to each of them was revealed. In medical ethics, principlism appears primarily as an important practical approach that allows instrumentalization of decision-making in ethically complex situations of treating patients, conducting biomedical and clinical research. The sources of the original four principles, which are recognized by the majority of theorists of principlism, have been clarified. Among such sources, the so-called Belmont report, which names three principles, is of secondary but big importance: the principle of respect for the individual; the principle of beneficence and the principle of justice. The main arguments, classical formulation and typical contexts of application of the four principles of bioethics presented by Tom Beaucamp and James Childress as the generally accepted basis of principlism are presented: respect for autonomy, nonmaleficence, beneficence and justice. European bioethicists subsequently complement and develop these four principles with other principles: dignity, integrity and vulnerability. The main directions of criticism of principlism are revealed: lack of specificity, uncertainty of practical application of ethical theory, possible contradiction between principles. The need for constant and systematic practice of applying ethical principles in making medical decisions is defined as an antidote to these shortcomings of principlism. It is noted that Beaucamp and Childress see such permanent practice through specification and balancing procedures.

Author Biography

Nataliia Boychenko, Shupyk National Healthcare University of Ukraine

Doctor of Philosophy, Professor of the Department of Philosophy and Foreign Languages. Scientific Secretary of the Ethics Committee of the Shupyk National Healthcare University of Ukraine. Author of the monograph “Modern University: Value-Ethical Dimension” (2015), articles on the philosophy of education, ethics and bioethics.


American College of Physicians. (2011). Why compassion is such an important part of practice. December ACP Observer. president.htm.

Beauchamp, T., & Childress J. (1994). Principles of Biomedical Ethics, 4-th ed. New York: Oxford University Press.

Schüklenk, U., & Singer, P. (Eds.). (2021). Bioethics: An Anthology. Fourth edition. Hoboken, NJ: Wiley-Blackwell.

De Grazia, D., & Millum, J. (2021). A theory of bioethics. Cambridge University Press.

Department of Health, Education, and Welfare & 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 subjectsof research.

Engelhardt, H. T. Jr. (1986). The Foundations of Bioethics. New York: Oxford University Press.

Faden R. R., Beauchamp T. L., & King N. M. P. (1986). A History and Theory of Informed Consent. New York: Oxford University Press.

Gert, B., Culver, C. M., & Clouser, D. K. (1997) Bioethics: A Return to Fundamentals. New York: Oxford University Press.

Ghooi, R. B. (2011). The Nuremberg Code-A critique. Perspectives in clinical research 2(2), 72–76.

Gross, M. L. (2004). Bioethics and Armed Conflict: Mapping the Moral Dimensions of Medicine and War. The Hastings Center Report 34(6), 22-30.

Jahr, F. (1927). Bio-Ethik. Eine Umschau über die ethischen Beziehungen des Menschen zu Tier und Pflanz. Kosmos. Handweiser für Naturfreunde 24(1), 2-4.

Jecker N. A. S., Jonsen A. R., & Pearlman R. A. (2007). Bioethics: an introduction to the history methods and practice (2nd ed.). Boston, MA: Jones and Bartlett Learning.

Jonsen, A. R. (1998). The Birth of Bioethics. New York: Oxford University Press.

International Military Tribunal. (1949–1953). Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law № 10. Nuremberg, October 1946 – April 1949. Washington, D.C.: U.S. G.P.O.

Levinas, E. (1995). Ethics and Infinity. Trans. by R . A. Cohen. Pittsburgh: Duquesne University Press.

Pellegrino, E. D. (1999). The origins and evolution of bioethics: some personal reflections. Kennedy Institute of Ethics journal 9(1), 73–88.

Potter, V. R. (1971). Bioethics: bridge to the future. Englewood Cliffs, NJ: Prentice-Hall.

President’s Council on Bioethics (U.S.). (2008). Human dignity and bioethics: essays commissioned by the president’s council on bioethics. President’s Council on Bioethics. Retrieved May 16 2023 from

Rawls, J. (1971). A Theory of Justice: Original Edition. Cambridge, Mass: The Belknap Press of Harvard University Press.

Rendtorff, J. D. & Kemp, P. (Eds.) (2000). Basic Ethical Principles in European Bioethics and Biolaw. Copenhagen and Barcelona: Centre for Ethics and Law (Copenhagen) & Instituto Borja de Bioética (Barcelona), 2 vols.

Veatch, R. M. (2003). The Basics of Bioethics. 2nd ed. Prentice-Hall, NJ: Upper Saddle River.

Sullivan, M. D. (2016). Respecting and Promoting Patient Autonomy in Research, End-of- Life Care, and Chronic Illness Care. The Patient as Agent of Health and Health Care: Autonomy in Patient-Centered Care for Chronic Conditions. (Pp. 41-74). New York, Oxford Academic.

Tännsjö, T. (2008). Understanding ethics: an introduction to moral theory. Second Edition. Edinburgh: Edinburgh University Press.

Ten Have, H. & Gordijn, B. (Eds.) (2014). Handbook of global bioethics. 4 Vols. Dordrecht: Springer.

Ten Have, H. (2001). Foundations and history of bioethics. Ten Have, H., & Gordijn B. (Eds.), Bioethics in a European Perspective. (Pp. 17-50). Dordrecht: Kluwer Academic Publishers.

World Medical Association. (1948). Declaration Of Geneva. Adopted by the General Assembly of The World Medical Association. Geneva, Switzerland.

World Medical Association. (1949). International code of medical ethics. Adopted by the 3rd General Assembly of the World Medical Association. London, England. https://

World Medical Association. (1964). World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Helsinki, Finland.


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How to Cite

Boychenko, N. (2023). Principlism in bioethics: features and possible limitations. Filosofiya Osvity. Philosophy of Education, 29(1), 202–215.






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