Abstract

The American ethicists Tom L. Beauchamp and James F. Childress developed a framework of four ethical principles which are useful to analyze ethical complex cases in biomedicine. These four principles are respect for autonomy, beneficence, nonmaleficence, and justice. Beauchamp and Childress believe that their approach to manage ethical difficult cases is cross cultural i.e. that it can be used in different cultures such as American, European, and Asian cultures. However, some of their critics claim that the framework of the four principles is American in nature and for this reason it cannot be used in other cultures. Beauchamp and Childress’ theory is influential worldwide where it is taught to, and used by, students, nurses, physicians etc., therefore it is important to explore whether there are indications that this theory is actually useful in other cultures than the American and whether the theory should be modified for this purpose. This article specifically examines how to investigate whether there are indications that the principles and method of Beauchamp and Childress are cross cultural. First, the theory of Beauchamp and Childress is introduced. Then a suitable method for studying the theory empirically is outlined. This empirical method was used for a Danish empirical study where Danish oncologists and Danish molecular biologists were interviewed. This study is reviewed in the article and it is pointed out that this study indicates that the four principles of Beauchamp and Childress are important for Danish biomedical practice. Lastly, it is concluded that similar empirical studies can be made in other cultural settings to investigate whether there are indications that the ‘principles approach’ of Beauchamp and Childress is cross cultural.

Highlights

  • Patients may be in difficult situations, and frequently it is hard to decide what ought to be done

  • This study was based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company

  • This study indicated that oncology physicians and molecular biologists employed in a private biopharmaceutical company had the specific principle of beneficence in mind in their daily work

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Summary

Introduction

Patients may be in difficult situations, and frequently it is hard to decide what ought to be done. A patient could suffer from serious cancer and be in deep crisis In this situation it is difficult to choose among possible options of standard treatment, experimental treatment, complementary treatment, and maybe withstanding treatment. Childress have developed a framework of four ethical principles which may be a good starting point in such situations These four principles are respect for autonomy (respecting the decisionmaking capacities of autonomous persons), nonmaleficence (avoiding the causation of harm), beneficence (providing benefits and balancing benefits, burdens, and risks), and justice (fairness in the distribution of benefits and risks) [1,2]. If the principles conflict they ought to be specified and balanced [1]

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