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 …

What is the organizational structure of Hume’s essay? The first three paragraphs are purely introductory and somewhat incidental. To someone untutored in Hume’s general religious skepticism, these opening remarks might appear to be the vain boasts of a philosopher in praise of philosophy. More plausibly, his opening remarks are stage-setting devices. They prepare the reader not for what Hume will argue but rather for how he will uncompromisingly challenge commonly held presuppositions about the sensitive issue of suicide. His comments are methodological or perhaps meta-philosophical in character. In more contemporary language, Hume is promoting the following two theses in these introductory paragraphs, each of which has to do with the inadequacy of non-philosophical foundations for reaching conclusions about the morality of suicide.

What grounds and justifies conclusions in medical ethics? Is the source external or internal to medicine? Thee influential types of answer have appeared in recent literature: an internal account, an external account, and a mixed internal / external account. The first defends an ethic derived from either the ends of medicine or professional practice standards. The second maintains that precepts in medical ethics rely upon and require justification by external standards such as those of public opinion, law, religious ethics, or philosophical ethics. The third claims that distinct medical ethics have emerged from distinct cultural frameworks, each with norms that govern physicians. There is merit in each perspective, but each overreaches its supporting arguments and fails to appreciate what is legitimate in the theses of its competitors. I propose a fourth account that offers a way to escape limitations of the other three, while retaining their most attractive features.

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 12.4 (2002) 389-390 [Access article in PDF] IOM Report on the System for Protecting Human Research Participants Tom L. Beauchamp* In response to society's concerns about the use of human subjects in research, the Department of Health and Human Services commissioned the Institute of Medicine to perform a comprehensive assessment of current systems of research participant protection in the U.S., including recommendations for reform (Committee 2002). Although the committee declared its frustration over the lack of data, it found ample evidence to indicate that there are pivotal weaknesses in the current system. First, it discovered dissatisfaction with the current system from virtually every quarter and at virtually every level. Second, it found evidence that IRBs are under severe strain and performing inadequately. Third, it found that the existing regulatory framework—the IRB system and the Common Rule—has not and probably now cannot react adequately to the constantly evolving research environment. Some of these problems might be handled through federal agencies, but the committee holds that the problems are more extensive and will require additional institutional support and professional attention.The committee found that federal protection requirements should be extended to every research project—private, public, or otherwise. Subjects should be, in this respect, equally protected in privately sponsored research.The committee found that the IRB system is in important respects a failure, especially when it alone is relied upon for ethics reviews in institutions. One set of problems concerns the proper education of IRB members. The committee recommends that all members henceforth be given a specialized knowledge of human research ethics. It finds that IRB deliberations commonly have been dominated by scientists, who often marginalize the perspectives of nonscientist members. It therefore recommends that unaffiliated members, nonscientists, local community representatives, and those representing the participant-perspective comprise at least 25 percent of the membership. It also recommends that no protocol be approved without three-quarters of the voting members concurring. [End Page 389]The committee recommends that institutions distinguish review aimed at (1) scientific merit, (2) conflict of interest, and (3) general Ethics Review. The distinction should more evenly distribute the work of institutional ethics review. The IRB should not conduct the initial scientific review nor should it be spending the bulk of its time purely in examining either scientific merit—as many IRBs now do—or conflict of interest. Instead, the conclusions of the scientific review should be submitted to the IRB for ethics-focused deliberations. Problems of both financial and nonfinancial conflicts of interest should be handled similarly, preferably by a committee properly distanced from the institution's interests.The committee underscores that consent must be understood on the model of an interactive dialogue between research staff and participants and not merely as a signed form or single-disclosure event. Conversations between the participant and the research staff should begin even prior to the point of enrollment and should be reinforced during each stage of the research. The committee finds that informed consent conversations and documents too often are being conceived as risk management tasks gauged to protect the institution from liability.The committee also believes that the system of protections established by a research program should be open to the public in order to foster and maintain the community's trust. Open communication should occur among all relevant stakeholders. The committee notes that currently no centralized system exists for the dissemination of information about clinical trials and other research activities.It urges reconsideration of present policies regarding compensation, finding that many research organizations provide at least short-term medical care for those who are injured, but that few organizations cover all potential risks and that many organizations have no effective policy of compensation. The report holds that providing reasonable compensation for bona fide instances of research harm is the only just system and is necessary to avoid diminished public trust.The committee holds that establishing the appropriate culture in research institutions will require sustained efforts to educate researchers, research administrators, IRB members, and...