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Four scenarios
  1. R Gillon
  1. Imperial College London, UK
  1. Correspondence to:
 Professor R Gillon, Centre for Primary Care and Social Medicine Ethics Unit, Imperial College London, Charing Cross Campus, Reynolds Building, St Dunstan’s Road, London W6 8RP, UK; 

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Promoting respect for the four principles remains of great practical importance in ordinary medicine

The following are four “scenarios” with brief outlines of how Raanan Gillon has analysed them using the “four principles” approach. These are the four cases that the commentators were asked to analyse.

Professor Gillon has for many years advocated the use of the Beauchamp and Childress four principles approach as a widely and interculturally acceptable method for medical ethics analysis (he has called himself their unpaid European agent). At present there seems to be a backlash by some bioethicists against this approach, with among others, adherents of feminist ethics, narrative ethics, virtue ethics, and various varieties of regional ethics claiming to offer better approaches to medical ethics.

At Raanan Gillon’s request this special issue of the Journal of Medical Ethics is intended to focus on this aspect of his work, with a view not only to discussing the issue of how different approaches to medical ethics are and/or are not compatible with the four principles approach but also to make clear to JME readers what alternative ethics analysis method is preferred and used by the various commentators.


In the first scenario, that of the “standard” Jehovah’s Witness case, a competent adult patient loses a massive amount of blood from a blood vessel bleeding in an acute duodenal ulcer. The best chance of …

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