Principlism: when values conflict

To ensure morally justified decisions, clinicians are encouraged to apply ethical theories and frameworks. Beauchamp and Childress’ ‘Four Principles’ approach to medical ethics, or ‘Principlism’ for short, is highly regarded as a simple methodology for considering ethical dilemmas, and is common to many undergraduate clinical programmes. On occasion, ethical dilemmas are complex and one or more of the four principles come into conflict with each other. Critics of the approach have suggested that there is a lack of guidance on how to resolve this conflict.

This paper will argue that principlism facilitates an organised and thorough method of reflecting upon an ethical problem and is well suited to the pre-hospital setting. The problem of how to resolve conflicts between the principles will be explored, demonstrating the merit of the approach through its application to a real-life moral problem from the pre-hospital setting.