New Being Press, 2449 Golf Road, Suite 3, Philadelphia, PA 19131. USA.
J Med Ethics. 2010 Sep;36(9):525-8. doi: 10.1136/jme.2009.031054.
For many, Thomas Beauchamp and James Childress have elaborated moral reasoning by using the four principles whereby all substantive problems of medical ethics (and of ethics more generally) can be properly analysed and cogent philosophical solutions for the problems can be found. It seems that their 'principlism' gets updated, with better features being added during the course of the six editions of Principles of Biomedical Ethics. Nonetheless, Beauchamp and Childress seem to have been losing their way when it comes to the common-morality justification, which is the epistemological (and perhaps metaphysical) backbone of their method, and this is shown more vividly in their most recent (2009) edition of Principles of Biomedical Ethics. The author points out what he calls the problem of 'thick in status, thin in content' in principlism. The problem exists because principlism cannot adequately explain how the prescriptive sense of common morality it supports is consistent with the existence of what Beauchamp and Childress call the 'legitimate moral diversity in the world'. Because of this problem, first, the practical end that principlism allegedly accomplishes (ie, providing practical moral guidelines in a relatively 'thick' content, based on common morality) is frustrated, and, second, principlism makes itself the method of common morality de jure and of moral pluralism de facto.
对于许多人来说，托马斯·比亚彻姆和詹姆斯·奇尔德里斯通过使用四个原则来详细阐述道德推理，通过这些原则，可以对所有医学伦理学（以及更广泛的伦理学）的实质性问题进行适当的分析，并为这些问题找到有力的哲学解决方案。他们的“原则主义”似乎在不断更新，在《生物医学伦理学原理》的六个版本中不断增加更好的特性。然而，当涉及到共同道德论证时，比亚彻姆和奇尔德里斯似乎已经迷失了方向，而共同道德论证是他们方法的认识论（也许是形而上学）的支柱，这在他们最近（2009 年）版的《生物医学伦理学原理》中表现得更为明显。作者指出了他所谓的原则主义中的“地位厚实，内容单薄”问题。这个问题的存在是因为原则主义无法充分解释它所支持的共同道德规范意义如何与比亚彻姆和奇尔德里斯所谓的“世界上合法的道德多样性”的存在相一致。由于这个问题，首先，原则主义据称实现的实践目的（即在共同道德的基础上，提供相对“厚实”内容的实践道德准则）受挫，其次，原则主义使自己成为共同道德的法定方法和道德多元主义的事实上的方法。
