- •Principlism
- •Jeffrey W. Bulger
- •Utah Valley State College
- •The Belmont Report
- •Thalidomide Case
- •Tuskegee Syphilis Study
- •Belmont Report And Its Three Core Principles
- •1. Respect for persons,
- •2. Beneficence, and
- •3. Justice.
- •1. Information
- •2. Comprehension
- •3. Voluntariness
- •Principlism: A Practical Approach To
- •Moral Decision-Making
- •Principlism as a Practical Approach
- •Specifying and Balancing
- •Incommensurable Beliefs
- •Principle Of Autonomy
- •1. Intention: The agent must intentionally make a choice.
- •3. Freedom: The agent must choose without substantial controlling influences.
- •Competence
- •Informed Consent
- •1. Autonomous authorization, and
- •2. Institutional authorization.
- •Intentionality
- •1. Express Consent: When the autonomous agent verbally consents.
- •2. Implied Consent: When the autonomous agent infers through an action, e.g., lifting an arm for a shot.
- •Understanding
- •2. Reasonable Person Standard: This position asserts that information disclosure is based on what a hypothetical “reasonable person” would consider as “material information.”
- •1. Therapeutic Privilege:
- •2. Therapeutic Placebos: Involves intentional deception or incomplete disclosure.
- •Freedom
- •1. Persuasion: Persuasion is being influenced by reason. Reasoned argument provides factual information and logical analysis for the promotion of autonomy, beneficence, nonmaleficence, and justice.
- •Principles of Beneficence and Nonmaleficence
- •1. knows exactly what the action or refrainment in question is, and
- •2. knows exactly towards whom the action is or is not to be directed. (e.g., Do not kill your brother.)
- •1. does not know exactly what the action or refrainment in question is, and
- •2. does not know exactly towards whom it is or is not to be directed. (e.g., Be charitable to others.)
- •1. Imperfect obligation.
- •2. Positive requirement of action.
- •3. Agent need not be impartial.
- •4. Failure to act positively rarely results in legal punishment.
- •1. Perfect obligation.
- •2. Negative requirement of refrainment.
- •3. Agent must be impartial.
- •4. Failure to refrain often results in legal punishment.
- •1. a perfect obligation, such as a parent’s responsibility in providing good nutrition, clothing, shelter, and psychological support for their children, and
- •3. impartial, such as a parent’s responsibility to benefit their children by being fair and impartial with them, and
- •4. legally necessary, holding someone legally accountable, such as a parent whose violation of beneficence, like a lack of nutrition for their children, results in legal intervention.
- •1. an imperfect obligation, such as not harming others, however that may be defined, and towards whoever that may be directed,
- •3. implemented partially, such as a parent not harming a particular child, and
- •4. legally neutral, such as an agent not being held legally accountable for maleficence; for example, the teasing of a sibling.
- •1. My spouse gives me 100 units of benefits and 13 units of burdens for a total of 87 units.
- •2. Pepperoni pizza gives me 10 units of benefits and 3 units of burdens for a total of 7 units.
- •3. Therefore, I should be willing to trade my spouse for 13 pepperoni pizzas.
- •Principle of Justice
- •2. Moral authority: Government controlled morality vs. individual controlled morality.
- •Economic Axis
- •Social Morality Axis
- •Four Quadrants
- •Diversity in the Compass
- •Application of Justice
- •Conclusion
- •Notes
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Teaching Ethics, Fall 2007 |
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Belmont Report And Its Three Core Principles
Principlism is a moral approach based on judgments that are generally accepted by our cultural tradition and that are particularly relevant to biomedical ethics (See Table 1).
1.Respect for persons,
2.Beneficence, and
3.Justice.
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BELMONT REPORT |
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PRINCIPLES |
APPLICATIONS |
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Respect for Persons |
Informed Consent |
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1. |
Individuals should be |
1. Information |
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treated as autonomous |
a. |
Procedures |
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agents. |
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b. |
Purpose |
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2. |
Persons with diminished |
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c. |
Risks and benefits |
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autonomy are entitled to |
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d. |
Alternatives |
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protection. |
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e. Opportunity to ask ques- |
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tions and to withdraw at |
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any time. |
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2. Comprehension |
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3. Voluntariness |
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Beneficence |
Assessment of Risks and |
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1. |
Human subjects should |
Benefit |
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not be harmed. |
1. The nature and scope of |
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2. |
Research should maximize |
risks and benefits. |
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possible benefits and mini- |
2. The systematic assessment |
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mize possible harms. |
of risks and benefits. |
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Justice |
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Selection of Subjects |
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The benefits and risks of |
There must be fair procedures |
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research must be distributed |
and outcomes in the selection |
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fairly. |
of research subjects both indi- |
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vidually and socially. |
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Table 1.
