After an examination of the four cardinal bioethical principles which define Principlism — autonomy, beneficence, non maleficence and justice — an explication of Joseph Fletcher’s theory of Situationism is undertaken.
The conclusion of this Article is that when an ethical dilemma arises and is “tested” as to its moral efficacy, rather than judge the acts in question in order to determine whether they are in conformance with one of the four bioethical principles, it is more humane and practical to determine the ethical propriety of questioned conduct by use of a situation ethic which in fact is more sensitive. This ethic “validates” conduct which is compassionate, merciful and loving — particularly when issues of end-of-life care arise. Accordingly, when medical conduct alleviating pain and suffering for patients in a futile state is pursued, common sense morality and sound medical practice should dictate that all reasonable and lawful steps be followed which allow as dignified a death as is possible.
George P. Smith, II, Applying Bioethics in the 21st Century: Principlism or Situationism?, 30 J. CONTEMP. HEALTH L. & POL’Y 37 (2013).