he term principle can be defined in several ways. A principle may refer to a basic truth, law or assumption. For example, a principle may take the form of a law or rule that describes a natural phenomenon. With respect to ethics, the term principle can refer to a generalization that can be used in moral reasoning or a specific rule of good conduct.

A number of specific and commonly recognized moral principles have been articulated for application in the realm of health care ethics. Some ethicists, notably Beauchamp and Childress (2004), have used such principles as a primary framework for ethical analysis and dialogue. In this approach, referred to as principlism, each principle represents a serious, though not absolute, moral duty that must be weighed against other duties in resolving an ethical conflict or dilemma.

Although very influential in contemporary bioethics, principlism has been widely criticized on several counts. For example, because principlist approaches are not rooted in particular overarching values, there is no widely accepted standard for resolving the inevitable conflicts between principles. Individual principles may be interpreted or weighted differently by different individuals or may not accurately represent particular cultural viewpoints and assumptions. In fact, there is no common agreement on exactly what principles are morally relevant and to what extent some principles are more or less foundational to other principles. Finally, critics contend that principlist approaches fail to consider important aspects of character and virtue-based approaches or relational approaches such as care ethics. Nonetheless, the insightful use of moral principles has proven an intuitively appealing and widely recognized foundation for dialogue in health care ethics.