RT Journal Article SR Electronic T1 Judgement and the role of the metaphysics of values in medical ethics JF Journal of Medical Ethics JO J Med Ethics FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP 365 OP 370 DO 10.1136/jme.2005.012518 VO 32 IS 6 A1 T Thornton YR 2006 UL http://jme.bmj.com/content/32/6/365.abstract AB Despite its authors’ intentions, the four principles approach to medical ethics can become crudely algorithmic in practice. The first section sets out the bare bones of the four principles approach drawing out those aspects of Beauchamp and Childress’s Principles of biomedical ethics that encourage this misreading. The second section argues that if the emphasis on the guidance of moral judgement is augmented by a particularist account of what disciplines it, then the danger can be reduced. In the third section, I consider how much the resultant picture diverges from Beauchamp and Childress’s actual position.