Bioethical Principlism as Bioethical Globalism : A Critical Appraisal from a Confucian Perspective

This paper offers a Confucian critique on bioprinciplism proposed by T. Beauchamp and J. Childress.

Beauchamp and Childress’ bioprinciplism version of global bioethics has apparently succeeded. The four principles they have proposed have been adopted generally in every region of the world (from the West to the East) and broadly in every field of inquiry (from clinics to biomedical research), regardless of people’s particular religious, cultural, or moral convictions. This paper will demonstrate that this version of global bioethics must fundamentally fail. Beauchamp and Childress identify two features of their four principles: first, the principles are “broad, abstract, and content-thin” so that “they are indeterminate and thus require further specification to generate more definite content”; moreover, “because they are not ranked a priori…, balancing or specification is required when [they] conflict” so that they “generate norms of particular moralities, including particular sociocultural traditions and professional moralities.” However, people from different moral traditions readily specify and rank these principles according to the particular moral norms they are practicing in their traditions (while such norms differ from tradition to tradition and are incommensurable with each other). Consequently, although they are apparently “applying” the four “universal” principles, what they are actually producing and practicing are different regional bioethics substantiated by their particular moral norms. In some regions, a typical way to employ the four-principle approach is to rule that the principle of respect for autonomy should trump the other three principles, while in other regions the principle of beneficence often dominates, even if neither is what Beauchamp and Childress intended. Thus, the “universal” application of bioprinciplism does not help resolve concrete bioethical dilemmas universally. This paper draws on the Confucian understanding of the nature of morality in terms of ritual to argue why this principlist version of global bioethics is deeply flawed.