Revisiting Principlism in the Age of Big Data: Why Justice Must Redefine Informed Consent

Beauchamp and Faden’s principlist approach in A History and Theory of Informed Consent subordinates justice to autonomy and beneficence, asserting that issues of informed consent are not fundamentally problems of social justice. Medical data, especially in the era of Big Data and AI-driven medicine, often benefits privileged groups while reinforcing health inequities. Traditional autonomy-based informed consent is impractical at this scale, necessitating a justice-centred alternative. Drawing on Reinhold Niebuhr’s Christian Realism as well as some feminist ethics of care approaches, this paper argues for an agape-centred model of justice that prioritises collective responsibility over individual choice. This approach advocates for independent institutions to govern data as a public good, ensuring equitable distribution and democratic oversight.