A Knock at the Door: A Contractualist Approach to and Defense of Principlism

What role, if any, should principlism—the “four principles approach” popularized by Tom Beauchamp and Jim Childress—play in bioethics today? In the wake of Tom Beauchamp’s recent death (February 19, 2025), I argue that a “contractualist-principlism” has the power to preserve principlism’s best insights while addressing some of its most serious objections: 1) its constrained moral perception; 2) its want of a method for adjudicating conflicting claims; and 3) its lack of theoretical unity. Moreover, a “contractualist-principlism,” based on the work of T. M. Scanlon, suits the needs not only of bioethics but also of the emerging field of anti-poverty ethics, which also focuses on the well-being and autonomy of the vulnerable, and the just distribution of life-saving resources. Finally, to complement my contractualist approach to principlism, I conclude with a contractualist defense of principles—in particular, as helpful heuristics or shortcuts for both moral perception and judgment.