Principles, rules, and the deflation of the good in bioethics

Abstract

Summary Prior to the Nuremberg Code, German Law had prohibited research on subjects without their consent. Yet, German Law could not restrain the Nazi research machine. Likewise, the United States Public Health Service continued research on poor black men in the southern US for 25 years after the promulgation of the Nuremberg Code. Once the Tuskegee Experiments were exposed, it prompted philosophers to articulate the more general and philosophically robust norms and principles that should ground and guide all future research and practice. Yet, this move to more general principles results in the deflation of metaphysical concepts traditionally thought necessary for ethics, namely the concept of the good and the concept of persons. Put differently, modern principles of biomedical ethics that seek to avoid pluralism and relativism grounds its ideas in the philosophy of right action at the expense of the philosophy of good. This essay argues that, because medicine is aimed at health, and the goods possible for persons in health, any ethics of medicine must be grounded in a philosophy of the goods for persons and goods of persons.