Hodges Kevin E, Sulmasy Daniel P
University of Notre Dame, USA.
Kennedy Inst Ethics J. 2013 Sep;23(3):275-96. doi: 10.1353/ken.2013.0011.
The theory of principlism elaborated by Beauchamp and Childress in Principles of Biomedical Ethics has become extremely influential in bioethics. The theory employs the idea of the common morality as a foundation for the principles of autonomy, beneficence, nonmaleficence, and justice. According to this account, the content of the common morality is universal and constant, while variability in morals is due to the fact that the issue of who is included within the scope of moral status evolves over time. This suggests that issues of moral status are not part of the common morality at all, and this presents a conundrum: questions of moral status seem central to any substantive account of justice, and any conception of the common morality that excludes moral status therefore seems inadequate for supporting a robust principle of justice. We argue that proponents of common morality theory are left with four options: (1) making moral status a part of the objective common morality and ignoring evidence that views about moral status do seem to vary over time and place; (2) excluding justice from the substantive content of the common morality; (3) taking common morality to be an imperfect approximation of an independently justified and universal foundationalist ethic against which the common morality is judged; or (4) weakening claims about the universality of common morality, thereby allowing the common morality to support a variety of principles of justice applicable only within particular communities that have specified the scope of moral status. We suspect that proponents of common morality theory will not view any of these options favorably, which raises questions about the ultimate contribution of that account.
博尚和奇尔德雷斯在《生物医学伦理学原理》中阐述的原则主义理论在生物伦理学领域极具影响力。该理论将共同道德的理念作为自主、仁爱、不伤害和公正原则的基础。根据这一观点,共同道德的内容是普遍且恒定的,而道德观念的变化是由于道德地位范围内所涵盖的对象这一问题会随着时间演变。这表明道德地位问题根本不属于共同道德的范畴,而这就产生了一个难题:道德地位问题似乎是任何实质性正义理论的核心,因此,任何排除道德地位的共同道德观念似乎都不足以支持一项强有力的正义原则。我们认为,共同道德理论的支持者面临四种选择:(1)将道德地位纳入客观的共同道德之中,而忽略关于道德地位的观点似乎确实会随时间和地点而变化的证据;(2)将正义排除在共同道德的实质性内容之外;(3)将共同道德视为对一种独立论证且普遍的基础主义伦理的不完美近似,以此来评判共同道德;或者(4)弱化关于共同道德普遍性的主张,从而使共同道德能够支持仅适用于特定社群(这些社群已明确道德地位范围)的各种正义原则。我们怀疑共同道德理论的支持者对这些选择都不会满意,这就引发了关于该理论最终贡献的疑问。