This article critically examines appeals to common morality within Beauchamp and Childress's Principles of Biomedical Ethics. I examine how this aspect of their account relates to Kant's account of morality. I consider criticisms against principlism on the basis that medical ethics cannot be grounded on a common morality because of the responsibilities and duties specific to medical practice. I suggest these arguments do not deny the possibility of universal moral principles; rather they demonstrate how the actions and duties that best instantiate these principles are context-specific and can differ between organizations.