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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.
THE "STANDARD" JEHOVAH'S WITNESS CASE
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 saving his life is an urgent blood transfusion along with operative intervention to arrest the bleeding. The patient refuses blood but asks for treatment instead with the best available non-blood products, and surgery, accepting the substantial risk that surgery without blood transfusion is much less likely to save his life than surgery with blood transfusion. Raanan Gillon analyses this case along standard four principles lines, and concludes: that the patient's wishes ought to be respected because, briefly summarised, the patient's autonomy is thus respected, the patient's own assessment of harms and...