Principlism, common morality and the normative independence of biomedical ethics

Since the emergence of contemporary bioethics in the 1970s, no theoretical approach has proved more influential than principlism. Yet no critics have shaped its development more profoundly than Bernard Gert, K. Danner Clouser, and Charles Culver. This article reassesses their critique of Beauchamp and Childress's framework and examines the replies offered in the eighth edition of Principles of Biomedical Ethics. I argue that this debate reveals not merely competing theoretical commitments but two fundamentally incommensurable paradigms:a "philosophy-to-practice" orientation that derives bioethical norms from systematic moral theory, and a "practice-to-philosophy" approach that abstracts principles from existing clinical guidelines. WhileGCC correctly identify principlism's lack of theoretical foundation as a structural limitation, they fail to re-cognize that a satisfactory biomedical ethics cannot be derived from an account of common morality alone. I conclude by suggesting a possible synthesis: grounding bioethical deliberation in the systematic framework of common morality while incorporating role-specific professional duties—duties that the principlist framework, given its demonstrated resonance with clinical practice, may help articulate.