principialismo

Principialismo, also known as principlism, is a framework in biomedical ethics that uses four core principles to guide moral decision making: autonomy, beneficence, non-maleficence, and justice. It was formulated by Tom Beauchamp and James F. Childress in the late 1970s and popularized in their influential work Principles of Biomedical Ethics. The approach is widely used in clinical and research ethics because it provides a concise set of broadly applicable norms.

Each principle has a general meaning: autonomy respects an individual's right to informed choice and self-governance; beneficence urges actions that promote the patient's good; non-maleficence requires avoiding or minimizing harm; justice concerns fair distribution of benefits, burdens, and resources. In practice, these principles function as prima facie duties that may conflict, requiring deliberation to determine which principle takes priority in a given situation. Beauchamp and Childress emphasize rational justification and public justification in balancing.

Criticisms include concerns that principlism is too abstract or culturally biased, emphasizes Western medical norms, may inadequately address social determinants of health, and can fail to resolve complex conflicts without additional ethical theories (such as care ethics, virtue ethics, or rights theory). Some critics argue it privileges patient autonomy at the expense of family or community values or clinicians' professional integrity. Proponents counter that it offers a transparent, flexible framework applicable to policy, clinical practice, and research ethics, and can be supplemented with context-specific considerations.