• Philosophical ethics
• principlism

In 2009, the 6th edition of Principles of biomedical ethics was published.1 Undeniably, the book is one of the most prominent and important works in biomedical ethics. When Tom L Beauchamp and James F Childress published the first edition 30 years ago,2 the field was still in a nascent state, full of hot topics but poor in method. It was, as K Danner Clouser portrayed it, ‘a mixture of religion, whimsy, exhortation, legal precedents, various traditions, philosophies of life, miscellaneous moral rules and epithets.’3 Against this background, it was a prime objective of Beauchamp and Childress to ‘bring some order and coherence to the discussion’ by means of a ‘systematic analysis of the moral principles that should apply to biomedicine’ (p vii).2

The basic structure of the book has remained constant throughout all editions; central chapters on each of the four principles (respect for autonomy, non-maleficence, beneficence and justice) and on the professional–patient relationship are framed by chapters on moral foundation, ethical theory and method. However, Beauchamp and Childress have shown an extraordinary ability and willingness continuously to take up new developments in the field, including critique on their account, and to update their book accordingly. Hardly any text passage of the 1st edition remained unchanged during the course of the following editions. For those who did not witness biomedical ethics from the beginning, consulting one of the previous editions can be interesting to get an impression of earlier states of the field, and how dynamic the development has been over the years. In this respect, the six editions of Principles of biomedical ethics published so far are a valuable historical document on the development of the field in the past three decades.

Fortunately, the authors …