Bioethics as a language game: probing the quality of moral guidance in principlism.

This essay asks what quality of moral guidance is offered via the language of principlism, the lingua franca of bioethics. In particular, I suggest three approaches to principlist language via Kant, Rawls, and Wittgenstein. A 'top down' Kantian view of language would seem to offer 'pure' or 'crystalline' moral guidance as autonomy, beneficence, non-maleficence, and justice function as linguistic links to draw us towards universal values up or out there to engage. While drawing upon Rawls, Beauchamp and Childress differ importantly by citing a universal morality grounded in reflective equilibrium amongst citizens. Principlism, hence, possesses a democratic form where the common morality depends upon a historically consistent majority position; what is 'universal' arises from political 'bottom up' discourses and processes. Wittgenstein, however, offers a notably different view of language that embraces the mystical and aesthetic realities of 'the ethical' while also affirming the grounding of language in everyday contexts. Not unlike the Stoics, language for Wittgenstein is ascetic in that it is a practice, a formative exercise that reveals the humility of language as an immanent 'game' that should nevertheless inspire one towards 'the ethical.'