Principlism
Encyclopedia
Principlism is a system of ethics based on the four moral principles of:

1. Autonomy--free-will or agency,

2. Beneficence--to do good,

3. Nonmaleficence--not to harm, and

4. Justice--social distribution of benefits and burdens.

Advocates for principlism argue that from the beginning of recorded history most moral decision-makers descriptively and prescriptively have used these four moral principles; that they are part of or compatible with most intellectual, religious, and cultural beliefs.

Principlism formalized into national and international law

Principlism was first formalized as a moral decision-making approach by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in a document called the Belmont Report
Belmont Report
The Belmont Report is a report created by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. Its full title is the Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research, Report of the National Commission...

 on April 18, 1979. The Commission came into existence on July 12, 1974 when the National Research Act
National Research Act
The National Research Act was enacted by the 93rd United States Congress. It created the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research to oversee and regulate the use of human experimentation in medicine. It was partly a response to the infamous...

 (Pub. L. 93-348) was signed into law. After four years of monthly deliberations, the Commission met in February 1976 for four days at the Smithsonian Institution’s Belmont Conference Center which resulted in a statement of the basic ethical principles of autonomy, beneficence, and justice, for biomedical and behavioral research. The Commission recommended that the Belmont Report be adopted in its entirety as a statement of the Department’s policy for the Secretary of Health, Education, and Welfare.

The Belmont Report’s cause of origin can be traced back to December 9, 1946 when the American Military Tribunal started criminal proceedings against 23 German physicians and administrators for war crime
War crime
War crimes are serious violations of the laws applicable in armed conflict giving rise to individual criminal responsibility...

s and crimes against humanity
Crime against humanity
Crimes against humanity, as defined by the Rome Statute of the International Criminal Court Explanatory Memorandum, "are particularly odious offenses in that they constitute a serious attack on human dignity or grave humiliation or a degradation of one or more human beings...

. During the trials, the Nuremberg Code
Nuremberg Code
The Nuremberg Code is a set of research ethics principles for human experimentation set as a result of the Subsequent Nuremberg Trials at the end of the Second World War.-Background:...

 was drafted for the establishment of standards for judging individuals who conducted biomedical experiments on concentration camp
Internment
Internment is the imprisonment or confinement of people, commonly in large groups, without trial. The Oxford English Dictionary gives the meaning as: "The action of 'interning'; confinement within the limits of a country or place." Most modern usage is about individuals, and there is a distinction...

 prisoners. The Nuremberg Code in its final form was established in 1948 and was the first international document that advocated voluntary informed consent
Informed consent
Informed consent is a phrase often used in law to indicate that the consent a person gives meets certain minimum standards. As a literal matter, in the absence of fraud, it is redundant. An informed consent can be said to have been given based upon a clear appreciation and understanding of the...

 for participants of research on human subjects.

Belmont report and its three core principles

Principlism is a moral approach based on judgments that are generally accepted by most intellectual, cultural and religious traditions. For example, the Belmont Report defines 3 key principles by which to judge the ethicality of biomedical and behavioral research. These principles are:

1. Respect for persons--Autonomy,

2. Beneficence--do good, and

3. Justice--specifically distributive justice wherein those who bear the burdens of research also receive its benefits.
National Commission for the Protection of Human Subject of Biomedical and Behavioral Research
1976 BELMONT REPORT Formalized in 1979 1976 BELMONT REPORT Formalized in 1979
PRINCIPLES APPLICATIONS
I. Respect for Persons--Autonomy
1. Individuals should be treated as autonomous agents.

2. Persons with diminished autonomy are entitled to protection.
Informed Consent

1. Information--Knowledge
a. Procedures
b. Purpose
c. Risks and benefits
d. Alternatives
e. Opportunity to ask questions and to withdraw at any time.

2. Comprehension--Understanding

3. Voluntariness--Freedom
II & (III). Beneficence & (Nonmaleficence)
1. Human subjects should not be harmed--Nonmaleficence.

2. Research should maximize possible benefits--Beneficence, and minimize possible harms--Nonmaleficence.
Assessment of Risks and Benefits

1. The nature and scope of risks and benefits.

2. The systematic assessment of risks and benefits.
IV. Justice

The benefits and risks of research must be distributed fairly.
Selection of Subjects

There must be fair procedures and outcomes in the selection of research subjects both individually and socially.

Principlism as a practical approach

Principlism has evolved into a practical approach for ethical decision-making that focuses on the common ground moral principles of autonomy, beneficence, nonmaleficence, and justice. The practicality of this approach is that principlism can be derived from, is consistent with, or at the very least is not in conflict with a multitude of ethical, theological, and social approaches towards moral decision-making. This pluralistic approach is essential when making moral decisions institutionally, pedagogically, and in the community as pluralistic interdisciplinary groups by definition cannot agree on particular moral theories or their epistemic justifications. However, pluralistic interdisciplinary groups can and do agree on intersubjective principles. In the development of a principlistic moral framework it is not a necessary condition
Necessary and sufficient conditions
In logic, the words necessity and sufficiency refer to the implicational relationships between statements. The assertion that one statement is a necessary and sufficient condition of another means that the former statement is true if and only if the latter is true.-Definitions:A necessary condition...

 that the epistemic origins and justifications of these principles be established. Rather the sufficient condition is that most individuals and societies, would agree that both prescriptively and descriptively there is wide agreement with the existence and acceptance of the general values of autonomy, nonmaleficence, beneficence, and justice.

Specifying and balancing

Once these principles have been established the practical activity then becomes that of specifying how the principles are to be used in specific situations and balancing the principles with the other competing moral principles. In using this approach, every moral decision will be dilemmatic in that the agent will be to some degree either morally right and morally wrong under a single principle, and/or there will be two or more competing moral principles and the agent will not be able to completely fulfill one or more moral principles without violating or competing with one or more other moral principles. Dilemmatic decision-making is not unusual when making pluralistic social decisions. The Bill of Rights in the United States Constitution
United States Constitution
The Constitution of the United States is the supreme law of the United States of America. It is the framework for the organization of the United States government and for the relationship of the federal government with the states, citizens, and all people within the United States.The first three...

 perfectly exemplifies this process. A citizen’s freedom of speech
Freedom of speech
Freedom of speech is the freedom to speak freely without censorship. The term freedom of expression is sometimes used synonymously, but includes any act of seeking, receiving and imparting information or ideas, regardless of the medium used...

, for example, does not allow someone to yell “FIRE” in a crowded theater when there is no fire as individual Constitutional Rights
Constitutional right
An inalienable right is a freedom granted by a Nature or the Creator's endowment by birth , and may not be legally denied by that government.-United States:...

 and Liberties are constrained by other individual rights
Individual rights
Group rights are rights held by a group rather than by its members separately, or rights held only by individuals within the specified group; in contrast, individual rights are rights held by individual people regardless of their group membership or lack thereof...

 and liberties and therefore they must be specified for specific situations and then balanced with the other inevitable competing principles.

Principlism, presented as a formal criterion, is a description and prescription
Linguistic prescription
In linguistics, prescription denotes normative practices on such aspects of language use as spelling, grammar, pronunciation, and syntax. It includes judgments on what usages are socially proper and politically correct...

 of moral decision-making with a deep and rich heritage that has yet to be formalized for pluralistic interdisciplinary groups. However, since most moral decision-making ultimately use this approach, in one form or another, moral decision making in pluralistic environments is possible as Principlism descriptively describes how people do in fact make moral decisions and prescriptively prescribes how people ought to act based on the intersubjective agreements of common morality. Instead of focusing on the epistemic differences of various philosophical and religious perspectives, Principlism focuses on the intersubjective agreements, and that is why it works so effectively in interdisciplinary pluralistic environments.

Principlism could be modified by adding or subtracting certain component principles yet practically the four principles of autonomy, beneficence, nonmaleficence, and justice are broad and comprehensive enough to sufficiently cover most cases and will provide the necessary output power for making interdisciplinary moral decisions.

Incommensurable beliefs

Even though pluralistic groups will in large part have shared universal values—Principlism, it is still clearly recognized that there is and will be incommensurable beliefs as to how the specification and balancing procedures found in the principlistic approach ought to be implemented. However, Principlism has the advantage over most other moral approaches in that Principlism emphasizes the shared interdisciplinary universal values
Universal values
Something is of universal value if it has the same value or worth for all, or almost all, people. This claim could mean two importantly different things. First, it could be that something has a universal value when everybody finds it valuable. This was Isaiah Berlin's understanding of the term...

 or principles and uses them in a systematic and transparent fashion resulting in a greater shared understanding and/or compromise. Certainly, Principlism does not claim to be able to solve all moral dilemmas caused by conflicts of beliefs, yet Principlism, without a doubt, has tremendous output power for practicing interdisciplinary moral decision-making.

Unified approach

Principlism is unified approach in that each moral principle
Morality
Morality is the differentiation among intentions, decisions, and actions between those that are good and bad . A moral code is a system of morality and a moral is any one practice or teaching within a moral code...

 seems to converge into each of the other three principles. For example, it can be argued that Principlism, as a comprehensive moral approach, is just another term for justice. To the extent that justice is socially valued because of how it effectively establishes autonomy, nonmaleficence, and beneficence, both personally and socially, it can be argued that Principlism only needs its fourth principle—justice, in order to fulfill its moral function. However, this argument can also be made with regards to each of the four principles as each principle seems to be able to include each of the other three principles. Personal autonomy results in the maximization of personal benefits—beneficence and the minimization of personal burdens—nonmaleficence within a legitimate social structure—justice. Likewise, nonmaleficence is maximized, by maximizing autonomy, beneficence, and justice and beneficence is maximized, by maximizing autonomy, nonmaleficence, and justice.

The fact that each of the four principles can be argued to be the supreme moral principle further validates the Principlistic approach towards moral decision-making. In other words, Principlism is a unified moral approach in which the addition of each principle strengthens the legitimacy of each of the other principles to the extent that each principle is specified and balanced using independent criteria and yet each principle still supports each of the other principles.

Science illustrates the importance and necessity of such unification. For example, if several academically distinct fields converge on a unified position that would generally give more credence towards that position. On the other hand, if one academic discipline has a hypothesis that contradicts several or all of the other academic disciplines, then that would be reason either to reject that hypothesis or at least to give it some pause. One example of such unification would be the comparison of evolution vs. creationism
Creationism
Creationism is the religious beliefthat humanity, life, the Earth, and the universe are the creation of a supernatural being, most often referring to the Abrahamic god. As science developed from the 18th century onwards, various views developed which aimed to reconcile science with the Genesis...

. Evolution converges in several academic fields such as Biology, Microbiology, Astronomy, Cosmology, Geology, Paleontology, Oceanography, Pathology, Medicine, Anthropology, and more. Creationism, on the other hand, is based on the non-academic discipline of religious faith
Faith
Faith is confidence or trust in a person or thing, or a belief that is not based on proof. In religion, faith is a belief in a transcendent reality, a religious teacher, a set of teachings or a Supreme Being. Generally speaking, it is offered as a means by which the truth of the proposition,...

 and is not supported by any of the empirical academic disciplines. As a result, creationism does not have the same academic stature as evolution and is therefore not considered as a plausible option by any of the empirical or rational academic disciplines. Therefore, other than creationism being a curious sociological, anthropological, or psychological phenomena of culture, religion, and/or belief, creationism has no place in academic empirical rational discourse. Of course academic sciences are by definition limited to empirical and rational discourses and some knowledge is clearly not of that category. For example, intersubjective experiences of sense data
Sense data
In the philosophy of perception, the theory of sense data was a popular view held the early 20th century by philosophers such as Bertrand Russell, C. D. Broad, H. H. Price, A.J. Ayer and G.E. Moore, among others. Sense data are supposedly mind-dependent objects whose existence and properties are...

 such as: sight, taste, smell, touch, hearing, and emotional states such as: love, and faith, are real and true experiences yet they elude rational and/or empirical quantification. However, since creationism claims to be an academic empirical conclusion, then it is legitimate to hold creationism to academic standards of universal academic consistency.

Principlism validates itself with its universally recognized moral principles of autonomy, nonmaleficence, beneficence, and justice. These principles are distinct moral attributes that converge and unifies moral decision-making even within pluralistic environments.

Goal of moral decision-making

The goal in moral decision-making is ultimately to specify and balance each of the four principles recognizing that there is no set hierarchical order of principles in that one or more moral principle may override one or more other moral principles depending on the circumstances. Specifying is the narrowing down or making the broad moral principles relevant for a particular decision and balancing is the attempt to maximize, as much as possible, all of the contributing or competing moral principles.

Applying principlism

The following is an approach that can be used towards applying Principlism to a particular case.

DETERMINE THE RELEVANT PARTIES
a. SPECIFYING THE RELEVANT PARTIES:
i. Positive Rights: (Obligation of others to provide something)
1. Subject, guardian, or social institutions
2. Relatives
3. Community
4. State government
5. Federal government
6. International government
7. Other
ii. Negative Rights: (Obligation of others to not interfere)
1. Subject, guardian, or social institutions
2. Relatives
3. Community
4. State government
5. Federal government
6. International government
7. Other
b. BALANCING THE RELEVANT PARTIES:
If appropriate put the relevant parties in hierarchical order, and/or indicate if one or more party has more compelling interests over one or more of the others.

I. AUTONOMY
a. SPECIFYING AUTONOMY: (Relate to negative and positive rights
Negative and positive rights
Philosophers and political scientists make a distinction between negative and positive rights . According to this view, positive rights permit or oblige action, whereas negative rights permit or oblige inaction. These permissions or obligations may be of either a legal or moral character...

 if relevant)
i. Personal Authorization
1. Intention: usually communicated by Express, Implied, or Tacit Consent
2. Substantial knowledge: usually provided using the Professional Practice Standard, Reasonable Person
Reasonable person
The reasonable person is a legal fiction of the common law that represents an objective standard against which any individual's conduct can be measured...

 Standard, or Subjective Standard
3. Substantial freedom: usually effected by such aspects as Persuasion, Coercion, and Manipulation
ii. Institutional Authorization
1. Intention: usually implemented by a signed document
2. Substantial knowledge: usually provided by a written document based on the Professional Practice Standard and/or the Reasonable Person Standard
3. Substantial freedom: If the document is not signed then the services are usually not provided
b. BALANCING AUTONOMY:
Balance the above by putting the obligations in hierarchical order, and/or by indicating if one has a more compelling interest
Strict scrutiny
Strict scrutiny is the most stringent standard of judicial review used by United States courts. It is part of the hierarchy of standards that courts use to weigh the government's interest against a constitutional right or principle. The lesser standards are rational basis review and exacting or...

 over the other.

II. NONMALEFICENCE
a. SPECIFYING NONMALEFICENCE:
i. What are the burdens of the various options for the subject and/or relevant parties?
ii. What personal and social rights
Social rights
Economic, social and cultural rights are socio-economic human rights, such as the right to education, right to housing, right to adequate standard of living and the right to health. Economic, social and cultural rights are recognised and protected in international and regional human rights...

 need to be considered?
1. Positive Rights: Obligation(s) of others for preventing or alleviating a harm
2. Negative Rights: Obligation(s) of others to not interfere in a potential or actual harm
b. BALANCING NONMALEFICENCE:
Balance the above by putting the obligations in hierarchical order, and/or by indicating if one has a more compelling interest over the other.

III. BENEFICENCE
a. SPECIFYING BENEFICENCE:
i. What are the benefits of the various options for the subject and/or relevant parties?
ii. What personal and social rights need to be considered?
1. Positive Rights: Obligations of others for providing a potential or actual benefit
2. Negative Rights: Obligations of others to not interfering in a potential or actual benefit
b. BALANCING BENEFICENCE:
Balance the above by putting the obligations in hierarchical order, and/or by indicating if one has a more compelling interest over the other.

IV. JUSTICE
a. SPECIFYING JUSTICE:
i. What are the legal or social issues
Social issues
Social issues are controversial issues which relate to people's personal lives and interactions. Social issues are distinguished from economic issues...

 with regards to the subject and/or relevant parties?
1. Personal Rights
Personal rights
Personal rights are the rights that a person has over their own body. Among personal rights are associated rights to protect and safeguard the body, most obviously protected by the torts of assault and battery...

 and Liberties as provided by the State, Federal, or International social structures
2. Social Rights and Liberties as provided by the State, Federal, or International social structures
3. Political Rights
Right
Rights are legal, social, or ethical principles of freedom or entitlement; that is, rights are the fundamental normative rules about what is allowed of people or owed to people, according to some legal system, social convention, or ethical theory...

and Liberties as provided by the State, Federal, or International social structures
ii. How do the above issues relate to positive rights (obligations of others to provide) and negative rights (obligations of others to not interfere)?
b. BALANCING JUSTICE:
Balance the above by putting them in hierarchical order, and/or by indicating if one has a more compelling interest over the other.

BALANCING THE FOUR PRINCIPLES
a. How many of the four principles are relevant for this case?
b. In this particular case, which principles are most influential and why?
c. Is it possible to maximize most or all of the four principles or do one or more of them override one or more of the others and why?

CONCLUSION

Summarize the specification and balancing within each of the four principles and then summarize the reasoning behind the balancing of the four principles and present the reasons why the chosen moral decision would have a higher probability of accomplishing the balancing end rather than some other decision.

Source of material

For detailed discussion of Principlism please refer to the article by Jeffrey W. Bulger in "Teaching Ethics" Vol. 8, #1, Fall 2007, pp. 81-100, Published by Society for Ethics Across The Curriculum. The above materials are parts of that article and were reproduced with the author's permission.
The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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