Tom Beauchamp

This autobiographical sketch is being published 50 years after I started as an assistant professor at Georgetown University in 1970. In this presentation, I cannot tell the full story of these 50 years. I write only about the formative years both before and after I was hired at Georgetown, and I emphasize two subjects. The first is the importance of the individuals who were massive influences on my intellectual development and aspirations. The second is the great importance of multidisciplinary work. I came from philosophy, a discipline that generally did not emphasize or particularly value multidisciplinary work, but I was transformed by individuals in other disciplines who directed me to this style of work. Almost sheer luck brought each of these influences into my life.

After expressing our gratitude to the commentators for their valuable analyses and assessments of Principles of Biomedical Ethics, we respond to several particular critiques raised by the commentators under the following rubrics: the compatibility of different sets of principles and rules; challenges to the principle of respect for autonomy; connecting principles to cases and resolving their conflicts; the value of and compatibility of virtues and principles; common morality theory; and moral status. We point to areas where we see common agreement with our commentators and respond to their critical evaluations.

This volume presents a framework of general principles for animal research ethics together with an analysis of the principles' meaning and moral requirements. Tom L. Beauchamp and David DeGrazia's comprehensive framework addresses ethical requirements pertaining to societal benefit and features a thorough, ethically defensible program of animal welfare. The book also features commentaries on the framework of principles by eminent figures in animal research ethics from an array of relevant disciplines: veterinary medicine, biomedical research, biology, zoology, comparative psychology, primatology, law, and bioethics.

Two positions that Rosamund Rhodes puts forward are the proper starting point for this commentary: 1. Medical ethics based on the common morality that uses a body of abstract principles or rules are not ‘an adequate and appropriate guide for physicians’ actions’. 2. We need, but do not have, a true professional medical ethics for physicians, which must be ‘distinctly different’ from ethics based on common morality. I will argue that both positions are mistaken. Rhodes does not analyse what she means by a professional ‘medical ethics’ and does not supply content for what she calls ‘medical professionalism’. ‘Common morality‘ is also not given a precise meaning. However, I set aside these problems of conceptual clarity and concentrate on a paradigm case of professional ethics for physicians (and others) in interactions with patients. My example is The Belmont Report. Belmont is almost certainly a document that, in the USA, has for four decades been highly influential on physicians, especially physicians engaged in clinical research. It is not merely research ethics. In full satisfaction of the American Board of Medical Specialties’ ‘definition of medical professionalism’, The Belmont Report puts forward a system of ethical principles showing that physicians and other health professionals must conduct research in the service of the public interest and the well-being of patient–subjects. The Belmont Report also satisfies the earlier delineated conditions of medical professionalism in the American Board of Internal Medicine’s ‘Physician Charter’, which are stated in terms of the ‘fundamental principles’ of the primacy of patient welfare, patient autonomy and social justice.1,1–3 Belmont more than satisfies these conditions of medical professionalism. Indeed Belmont may well be the source of the principles …

The four principles of biomedical ethics are widely used in the world for bioethical deliberation. These theoretical guides are useful for the analysis and resolution of particularly complex ethical controversies arising in clinical and biomedical fields. This chapter develops an analysis of the basic universal principles, the common universal morality, and some characteristics of each principle. Then it discusses some problems posed by critics who have provided alternative frameworks of principles that are nonuniversal. Finally, it shows how universal moral principles are connected to human rights, how rules and rights are specified to become detailed and practical for certain moralities, and how these ideas are connected with problems of justification in bioethics and biolaw.

Book reviewed in this article: Ethical Issues in Social Research. Edited by Tom L. Beauchamp, Ruth R. Faden, R. Jay Wallace, Jr., and LeRoy Walters. Baltimore: The Johns Hopkins University Press, 1982. xii + 436 pp. $25.00 (hardcover); $8.95 (paper). Ethics of Human Subject Research. Edited by Allan J. Kimmel, Jr. San Francisco: Jossey‐Bass, 1981. 106 pp. $6.95 (paper). Social Research Ethics. Edited by Martin Bulmer. New York: Holmes & Meier, 1982. xiv + 284 pp. $39.50 (hardcover); $14.50 (paper). The Ethics of Social Research: Field‐work, Regulation and Publication. Edited by Joan E. Sieber. New York: Springer‐Verlag, 1982. x + 187 pp. $23.50 (hardcover). The Ethics of Social Research: Surveys and Experiments. Edited by Joan E. Sieber. New York: Springer‐Verlag, 1982. xii + 249 pp. $23.50 (hardcover).

Chris Durante’s comments on my article about the compatibility of universal morality, particular moralities and multiculturalism indicate that we have very different approaches to and understandings of these three notions. Durante investigates multiculturalism from the perspective of political philosophy, whereas my approach is grounded in moral rather than political philosophy. Since he refers to his framework as an ‘ethico-political theory’, he may regard his account as a synthesis of moral and political philosophy, but this representation seems incorrect. He repeatedly refers to his discussions of multiculturalism using the language of ‘political ethics’, ‘political theory’, ‘political philosophy’, ‘political system’, ‘political ramifications’, ‘political order’, ‘political liberalism’, ‘political community’, ‘political society’, ‘political principles’ and related concepts. He bluntly states his view about the centrality of political theory: ‘Multiculturalism…is primarily concerned with establishing a political system with moral undertones rather than a moral system with political ramifications’. I take the reverse view. Durante assumes without argument that multiculturalism finds its origins and home in political philosophy; by contrast, I envision multiculturalism as primarily a moral theory about obligations to tolerate moral differences in the face of conflicts between cultural groups. I do not deny that political philosophy is relevant to the resolution of various problems of multicultural …

Business ethics raises many important philosophical issues. A first set of issues concerns the methodology of business ethics. What is the role of ethical theory in business ethics? To what extent, if at all, can thinking in business ethics be enhanced by philosophy, so as to provide real moral guidance? Another set of issues involves questions regarding markets, capitalism, and economic justice. There are related concerns about the nature of business organizations and the responsibilities they have to their members, owners, and society.The Oxford Handbook of Business Ethics is a comprehensive treatment of the field of business ethics as seen from a philosophical approach. The volume consists of 24 essays that survey the field of business ethics in a broad and accessible manner, covering all major topics about the relationship between ethical theory and business ethics. The chapters are written by accomplished philosophers who offer a systematic interpretation of their topics and discuss various moral controversies and dilemmas that plague business relationships and government-business relationships. Readers are thus presented with the major views that define the topic of the essay with critical discussions of those views, as well as topical bibliographies that identify key works in the field. In addition to philosophers who work in this area, the volume will be of interest to those in business and society seeking an up-to-date resource on this vital field. "This book is intended to provide an overview of the state of the field of philosophical business ethics. And Brenkert and Beauchamp are to be commended for having put together a collection of contributors and topics that is well-suited for this goal. The contributors are all first-rate scholars who have made important contributions to business ethics or cognate fields. They are also admirably diverse in age, ideology, and methodological approach, thus providing readers with a good glimpse into the wide range of scholarship that characterizes the field. The book will obviously be of interest to those for whom philosophical business ethics is a main area of interest. But the entries are clear and accessible enough to make the book of special value to at least two other groups: those whose approach to business ethics is not primarily philosophical will find here a useful 'crash course' in an alternative methodological approach to their own subject, and those philosophers who are not primarily interested in business ethics will be treated to a volume that makes clear the connection between business ethics and more standard philosophical subjects, and that will almost certainly provide them with new ways of thinking about both business ethics and other topics in value theory and political philosophy that are connected with business ethics in ways they might not have previously recognized. The selection of topics is also admirably comprehensive." - Notre Dame Philosophical Reviews.

In Unfit for the Future, Ingmar Persson and Julian Savulescu take up intriguing questions about whether human moral capacities should be improved to steer us in paths of improved decision making in confronting global crises. They assess the sufficiency of traditional moral practices and human nature as we confront ever more daunting moral and policy challenges. They start from the position that ‘human beings are not by nature equipped with a moral psychology that empowers them to cope with the moral problems that these new conditions of life create. Nor could the currently favoured political system of liberal democracy overcome these moral deficiencies’ (p. 1).1 The authors defend their starting point by presenting a variety of scenarios and conditions under which humans commonly fail to pursue a morally proper course of action even when aware that it is the proper course. Critical weaknesses include failed political will, biases to the near future, partiality to family and friends, insufficient sympathy, low levels of non-parochial altruism, underdeveloped conceptions of responsibility and a relatively weak sense of justice. The authors assess human nature as so morally deficient that it will be unable to successfully address impending and catastrophic problems at the global level: ‘Human beings now have at their disposal means by which they could undermine the conditions of worthwhile life on Earth forever ’ through their failures to deal with the depletion of essential natural resources, overpopulation, poverty, terrorism, anthropogenic climate change, nuclear weapons and use of biological weapons (p. 1, 2, 5, 37–39, 47–49, 60–63, 66–68, 75, 76, 83, 108, 109, 123, 127, 133, 134).1 This book's most convincing and sobering arguments are in its many passages on the depth and continuously increasing character of these catastrophic problems. It is the most persuasive presentation of the threats these …

: Phenomena of moral conflict and disagreement have led writers in ethics to two antithetical conclusions: Either valid moral distinctions hold universally or they hold relative to a particular and contingent moral framework, and so cannot be applied with universal validly. Responding to three articles in this issue of the Journal that criticize his previously published views on the common morality, the author maintains that one can consistently deny universality to some justified moral norms and claim universality for others. Universality is located in the common morality and nonuniversality in other parts of the moral life, called "particular moralities." The existence of universal moral standards is defended in terms of: (1) a theory of the objectives of morality, (2) an account of the norms that achieve those objectives, and (3) an account of normative justification (both pragmatic and coherentist).

In lieu of an abstract, here is a brief excerpt of the content:The Institute of Medicine’s Report on Non-Heart-Beating Organ TransplantationRoger Herdman (bio), Tom L. Beauchamp (bio), and John T. Potts Jr. (bio)In December 1997, the Institute of Medicine (IOM) released a report on medical and ethical issues in the procurement of non-heart-beating organ donors. This report had been requested in May 1997 by the Department of Health and Human Services (DHHS). We will here describe the genesis of the IOM report, the medical and moral concerns that led the DHHS to sponsor it, the process of producing it, and its conclusions. The analyses, findings, and recommendations of the report are also reviewed, in particular the central issues that led to suggestions for policy changes.Transplantation BackgroundAs a first step, some background in the relevant aspects of organ transplantation will prove useful. For the purposes of this analysis, “transplantation” involves the transfer of cells, tissues, or solid organs from one human to another to replace the structure or function of comparable body components that, through injury or disease, are defective or of inadequate function. The IOM report deals with solid organs, primarily kidneys and livers, whose blood supply is reconnected in the organ recipient, in contrast to cells, like bone marrow, and tissues, like corneas. A variety of donor types exists for organ transplantation, each with particular medical and scientific conditions.Living donors are healthy (and usually genetically related) individuals who volunteer to provide either a whole, paired organ such as a kidney or a section of an organ such as a liver. Cadaver donors are individuals who have died and from whom a full array of organs can be taken. “Heart-beating” cadaver donors are individuals who have suffered “brain death,” that is, irreversible cessation of function of the whole brain including the brain stem; and “non-heart-beating” donors (NHBDs) are individuals who are ill or injured, but not “brain dead,” and who have suffered cardiopulmonary death, that is, irreversible cessation of cardiac and respiratory function. NHBDs can be “controlled,” which means that [End Page 83] they can be sustained by artificial life support systems until a medical and family decision is made to terminate futile life support. This can be done at a scheduled time and in a controlled manner, and organs can then be recovered for transplantation. NHBDs can also be “uncontrolled,” which means that their hearts and breathing have stopped through disease or injury at an unexpected time or in an uncontrolled manner, and they cannot be resuscitated; the organs of some individuals of this description can be recovered for transplantation. The IOM report focused on both controlled and uncontrolled NHBDs and on problems specific to them.The questions that were asked and addressed in the IOM report became current and salient beginning in 1992 with the establishment of the University of Pittsburgh “Policy for the Management of Terminally Ill Patients Who May Become Organ Donors After Death.” This policy addressed controlled NHBDs and the ethical questions raised by their use; much of the discussion was reported in the June 1993 special issue of the Kennedy Institute of Ethics Journal. Public notice and anxiety about some of these concerns were sharpened and refocused by national and local media allegations of improper treatment of donors at the Cleveland Clinic in 1997, specifically premature—i.e., antemortem—recovery of organs and administration of drugs that allegedly might hasten donor death.The DHHS Request for StudyIt is not surprising that several federal actions would be taken in response to these events. Some, such as the results of a transplantation task force, remain largely internal to DHHS at this writing. Others are public, such as the IOM study of the NHBD situation. In May 1997, the DHHS initiated contacts with the IOM with the goal of exploring federal concerns about the medical and ethical treatment of NHBDs, in particular the allegations directed at the Cleveland Clinic.The DHHS response should be understood in at least three contexts. First, living donors and uncontrolled NHBDs were essentially the only donor types in the early days of transplantation in the United States. The technologies, ethics, and social acceptance of controlling and terminating life support for...

Hume wrote about fundamental similarities and dissimilarities between human and nonhuman animals. His work was centered on the cognitive and emotional lives of animals, rather than their moral or legal standing, but his theories have implications for issues of moral standing. The historical background of these controversies reaches to ancient philosophy and to several prominent figures in early modern philosophy. Hume develops several of the themes in this literature. His underlying method is analogical arg ument and his conclusions are generally favorable regarding the abilities in animals. Hume does not attribute a moral sense or capacity of judgment to animals, but he does suggest that their actions exhibit moral qualities, such as other-regarding instincts. Hume allows in-kind differences in both demonstrative reason and moral judgment, but in the domains of both causal reason and moral agency he believes there are differences of degree rather than of kind. Hume's most significant philosophical contribution was to move as far as anyone before him to a naturalistic explanation of human and nonhuman minds that invited psychological and epistemological examination of minds by using the identical methods and categories for man and beast.

Written by epidemiologists, ethicists and legal scholars, this book provides an in-depth account of the moral problems that often confront epidemiologists, including both theoretical and practical issues. The first edition has sold almost three thousand copies since it was published in 1996. This edition is fully revised and includes three new chapters: Ethical Issues in Public Health Practice, Ethical Issues in Genetic Epidemiology, and Ethical Issues in International Health Research and Epidemiology. These chapters collectively address important developments of the past decade. Three chapters from the first edition have also been reorganized: Ethicall Optimized Study Deisgns in Epidemiology, Ethical Issues in Epidemiologic Research with Children, and The Ethics of Epidemiologic Research with Older Populations. Instead of standing alone, these chapters have been integrated into chapters on informed consent, confidentiality and privacy protection, and community-based intervention studies.