A Structured Principlist Framework for Decision Making in Healthcare
Date of Award
Doctor of Philosophy (Ph.D.)
Michael Weber (Advisor)
Lynn Darby (Other)
John Basl (Committee Member)
Molly Gardner (Committee Member)
This dissertation puts forth the structured principlist framework, a practicable moral framework for guiding practioners’ thinking in a diverse healthcare setting and grounding accepted healthcare practices and policies. This novel moral framework builds upon on the work of Tom Beauchamp and James Childress in Principles of Biomedical Ethics, reorganizing the four primary bioethical principles – respect for autonomy, beneficence, non-maleficence, and justice – into two necessary and jointly-sufficient conditions for the permissibility of an action: The enabling condition, incorporating the deontic principles of respect for autonomy and justice, requires that a proposed action be authorized by the patient or proxy and adhere to current hospital policies & procedures. The favorability condition, incorporating the consequentialist principles of beneficence and non-maleficence, requires that the proposed action be reasonably expected to promote the health of the patient. In normative terms, the structured principlist framework is best described as a pluralistic framework that contains consequentialist considerations yet maintains deontic constraints. This structured framework was developed in response to several criticisms leveled against Beauchamp and Childress’s traditional principlist framework, ultimately capturing the benefits of bioethical principlism while providing a simplified, more guiding, and less capricious framework than the traditional framework. I argue for the structured principlist framework by demonstrating its usefulness when working through ethical conflicts at the clinical level as well as when formulating healthcare policies.
Gracyk, Tatiana Athena, "A Structured Principlist Framework for Decision Making in Healthcare" (2020). Philosophy Ph.D. Dissertations. 41.