What Is Wrong with Global Bioethics? On the Limitations of the Four Principles Approach

Within the latter half of the 30-year history of bioethics there has been an increasing pressure to address bioethical issues globally. Bioethics is not traditionally a theory-based enterprise, rather the focus has been problem related. With the introduction of the global perspective, theory has, however, become more important. One of the best known, probably the best known, theory of bioethics is the one presented by Tom L. Beauchamp and James F. Childress in their Principles of Biomedical Ethics in 1979. This theory is known as the “four principles” or the “Georgetown mantra” approach or “mid-level principlism.” It is the attempt to create a global framework for bioethics on the four principles—autonomy, justice, beneficence, and nonmaleficence—that I will scrutinize in this paper.