Principles and ethics in medicine

Principlism remains the dominant framework for addressing ethical quandaries in medical practice. It sets out four principles clinicians should consider that require specification to a particular set of circumstances. There is no hierarchy among the principles; any special prominence given to respect for autonomy is a cultural accretion that is not claimed by the authors of principlism. Principlism does not set out a single consistent or coherent moral theory. Instead, it summarizes for the clinician’s convenience the relevant reasoning of more fundamental theories, including those in which the emphasis is on a doctor’s intentions (deontological theories), those focusing on the outcome of doctors’ actions (consequentialist theories) and those relying on the nature and disposition of the doctor herself (virtue ethics).