Beyond the Principles of Bioethics: Facing the Consequences of Fundamental Moral Disagreement

Given intractable secular moral pluralism, the force and significance of the four principles (autonomy, beneficence, non-maleficence, and justice) of Tom Beauchamp and James Childress must be critically re-considered. This essay examines the history of the articulation of these four principles of bioethics, showing why initially there was an illusion of a common morality that led many to hold that the principles could give guidance across cultures. But there is no one sense of the content or the theoretical justification of these principles. In addition, a wide range of secular moral and bioethical choices has been demoralized into lifestyle choices; the force of the secular moral point of view has also been deflated, thus compounding moral pluralism. It is the political generation of the principles that provides a common morality in the sense of an established morality. The principles are best understood as embedded not in a common morality, sensu stricto, but in that morality that is established at law and public policy in a particular polity. Although moral pluralism is substantive and intractable at the level of moral content, in a particular polity a particular morality and a particular bioethics can be established, regarding which health care ethics consultants can be experts. Public morality and bioethics are at their roots a political reality

Physicians and the Community of Physicians: An Account of Collective Responsibilities

Editor\u27s note: This paper was read at the eighth annual University of Dayton Philosophy Colloquium, held in 1979. In the course of this paper, I will first present a sketch of some of the cardinal characteristics of professions, as these characteristics bear upon understanding their collective responsibilities. After a brief review of these distinguishing characteristics, I will compare the different senses of obligations that one can attribute to professions and then to their members. I will first examine what is involved in simply being a member of a profession, then a member of a profession within a particular governmental organization (i.e., a state), and finally, the collective responsibility of members of particular professional associations. On the basis of these background reflections, I will proceed to address some particular issues concerning the collective responsibilities of physicians

Bioethics in Latin America: 1989-1991

In our region, bioethics as an academic discipline and a public movement is still in its beginning stages. The historical changes resulting from scientific and technological advances in biomedicine and from the liberal and pluralist character of industrialized countries have barely begun to occur in the developing countries of Latin America, which remain largely “pretechnical” in their orientation. Bioethics as a secular discipline, with its principles of beneficence, autonomy, and justice, and its emphasis on the rational and free agent in the therapeutic relationship, has not yet reached Latin America.Facultad de Ciencias Médica