A Review Of The Debates On Principle In Contemporary American Bioethics

The debates on principle in contemporary American bioethics highlight the situation of fabricating bioethical theories. It can not only help in advancing the research of this subject but also propose some guideline for the medical practice to analyze the causes and ends of these debates.First, two wide-spreading theories of principle in contemporary American bioethics, i.e. the doctrine of four principles (respect for autonomy, non-maleficence, beneficence, justice) by Beauchamp and Childress and of permission principle by Engelhart, is recited in the present paper.Secondly, the controversy between the two above-mentioned doctrines is introduced and commented briefly on. The disagreement between them lies not in whether to establish principles or not, but in which principles to establish, which is not principal. Beauchamp and Childress, and Engelhart agree in establishing principles in bioethics, however, the formers seek after the material principles and the latter after the formal principle. The principle of respect for autonomy of the doctrine of four principles has common in essence with that of permission.Thirdly, the argument of both care ethics and casuistry versus the principalism which the doctrine of Beauchamp and Childress is called, is examined. Care ethics and casuistry disapprove radically the establishment and performance of any general material principle, which might be styled anti-principalist. The disagreement between them and the principalism is principal.Finally, the causes and ends of the debates on principle in contemporary American bioethics and their enlightenment to the present research of bioethics in China are discussed. The debates focus on which attitude toward life to deserve to have and how to deal with theuniversality of principles. They deepen and broaden the research of bioethics, but will never lead to an incontestable ultimate conclusion. From them we can draw some enlightenment in multiple dimensions, such as ideological, methodological and practical.