Tom Beauchamp and James Childress' seminal book, Principles of Biomedical Ethics, arose out of the Belmont Report in the late 1970s and serves as a common model in which clinical practitioners think through their ethical obligations and conflicts. The principlist approach has both ardent followers and critics, and the papers in this session will offer updated considerations of principlist approaches to bioethical questions in the context of religious scholarship and practice.
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.
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.