Principlism's Colonial Ties
Bibliographic record
Abstract
Since the establishment of modern bioethics in standardized medicine in the mid-late 20th century, the paradigm of Principlism has dominated its teleological landscape. This dominance is largely attributable to the success of the book, Principles of Biomedical Ethics. The multi-faceted nature of the titular principles defined within effectively describe, advise against, and adapt to a wide variety of ethical issues in medicine. However, these principles are not without flaw. This work will demonstrate that Principlism fails to adequately address its relation to and continuation of colonialism in clinical healthcare. More specifically, I argue that the Principlist paradigm is foundationally entangled with colonial thought – a mindset that permits the health- based oppression of Indigenous persons in countries such as Canada under the appearance of “ethical” conduct. This entanglement will be illustrated by presenting the core arguments of Principles of Biomedical Ethics against a backdrop of colonial wrongdoings involving medicine and Indigenous persons. The discord between these wrongdoings and the paradigm’s espoused righteousness reveal that Principlism avoids anti-colonial ideas about persons’ moral considerability – among other things – while also minimizing the importance of persons’ existence as communal and interrelated beings. The project concludes that these inadequacies can be improved upon by reconstructing the existing edifice of Principlist thought. This reconstruction has two facets: 1) presenting the existing core principles as virtue-based rules to better express an active obligation towards morally sound healthcare, and 2) adding a fifth, hitherto underappreciated, virtue rule about humility to the paradigm. Altogether, these revisions create a more robust paradigm that can approach and encourage anti-colonial healthcare. I do not suggest that the arguments presented here will definitively decolonize healthcare; this is but a step in that direction.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.011 | 0.043 |
| Scholarly communication | 0.008 | 0.005 |
| Open science | 0.001 | 0.007 |
| Research integrity | 0.002 | 0.007 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".