Principles of Biomedical Ethics
Tom Beauchamp and James Childress
First published 1979; now in its 9th edition.
Summary
This textbook introduced the four-principles approach that dominates medical ethics teaching: respect for autonomy, non-maleficence, beneficence and justice. The authors argue these principles are shared across many moral traditions, which makes them a practical common language for clinicians with different beliefs. None is absolute: they are 'prima facie' duties that must be specified for real cases and balanced when they conflict. The book also discusses the professional virtues and the relationships between doctors and patients, including truthfulness, privacy, confidentiality and fidelity. Critics argue that the principles can be too abstract, that they encourage box-ticking, and that they may underweight relationships, care and context. Many ethicists see them as a useful starting point rather than a complete theory.
Why it matters at interview
It is the origin of the Four Pillars. Knowing that the principles must be weighed — and knowing their limitations — lets you use them intelligently.
Key takeaways
- Four prima facie principles, none automatically overriding.
- Designed as a shared framework across different moral views.
- Principles must be specified and balanced in real cases.
- Critiques: abstract, can become a checklist, may neglect care and relationships.
How to use it
In Oxbridge or advanced ethics discussions, show you know the principles are a tool with limits — e.g. mention that care ethics emphasises relationships the pillars can miss.
Questions it helps with
- A 34-year-old woman who is a Jehovah's Witness has lost a lot of blood after childbirth. She is refusing a blood transfusion, which her doctors believe is necessary to save her life. What should the doctors do?
- One donor liver is available. Two patients need it: a 45-year-old with liver failure caused by alcohol, and a 45-year-old whose liver failure is caused by a genetic condition. Who should get it?