Reflecting on Principlism: Explaining, But Not Guiding, Clinical Ethics Analysis

Tom Beauchamp's contributions to the field of bioethics are as influential as they are numerous. Here we reflect on his intellectual legacy, specifically his role in establishing principlism as a method of bioethical analysis. Despite its prominence in medical ethics education, in our experience as clinical ethicists and researchers, we rarely analyze ethical issues the way principlism suggests, either in the clinic or our scholarship. In this paper, we consider the complex ways in which principlism may fruitfully relate to other approaches to ethical analysis in clinical ethics (e.g., the four-box method) as well as its relative strengths and drawbacks pedagogically, explanatorily, and translationally. We conclude with some reflections about the intellectual flexibility of principlism and its role in fostering interdisciplinary bioethics.