Veatch Robert M
Kennedy Inst Ethics J. 1995 Sep;5(3):199-218. doi: 10.1353/ken.0.0138.
While much attention has been given to the use of principles in biomedical ethics and increasing attention is given to alternative theoretical approaches, relatively little attention has been devoted to the critical task of how one resolves conflicts among competing principles. After summarizing the system of principles and some problems in conceptualizing the principles, several strategies for reconciling conflicts among principles are examined including the use of single-principle theories (pure libertarianism, pure utilitarianism, and pure Hippocratism), balancing theories, conflicting appeals theories, and lexical ordering. Then a mixed strategy is proposed in which consequentialist principles are balanced between themselves as are nonconsequentialist principles, after which the result of balancing the nonconsequentialist principles is lexically ranked over the result of balancing the consequentialist ones. Finally, strategies involving specifying and rule generation are discussed concluding that most current specification and rule-generating theories must involve some degree of lexical ordering of principles.
尽管生物医学伦理学中原则的运用已备受关注，且对替代性理论方法的关注也与日俱增，但对于如何解决相互冲突的原则之间的矛盾这一关键任务，却相对鲜有探讨。在总结了原则体系以及原则概念化过程中存在的一些问题之后，本文考察了几种协调原则冲突的策略，包括单一原则理论（纯粹自由主义、纯粹功利主义和纯粹希波克拉底主义）的运用、平衡理论、冲突诉求理论以及词典式排序。接着提出了一种混合策略，即让后果主义原则自身相互平衡，非后果主义原则也相互平衡，之后将非后果主义原则平衡的结果按词典式排序置于后果主义原则平衡结果之上。最后讨论了涉及具体规定和规则生成的策略，得出结论：当前大多数具体规定和规则生成理论都必须包含某种程度的原则词典式排序。
