What is the outcome of applying principlism?

The four principles approach to bioethics, an approach most associated with the work of Tom Beauchamp and James Childress, is supposed to provide a framework for reasoning through moral issues in medicine. One might wonder, if one were to guide one's thinking by the method suggested by principlism, will one identify and perform the objectively morally right action? Will one's decision making be justified, and consequently, will the action that flows from that decision itself be justified? In this paper, I show that principlism can, and has been, characterized in these two different ways. I also argue that when it is understood according to the first characterization, the view cannot be put into practice. However, when it is understood as an account of justification, there is reason to think that it is indeed action-guiding. Given the problems that confront the first version of the view, perhaps it is best to understand principlism, and biomedical ethical theories generally, not as action-guiding theories of right action, but rather, as procedures by which one's decisions and actions in medicine can achieve a reasonable degree of moral justification.