 There are other approaches to bioethics that embody alternatives to high theory. The first, casuistry, can in some sense be understood as a critical response to early versions of Beauchamp and Childress’ four principles approach. Recall a certain response to at least early versions of Beauchamp and Childress’ approach, namely that that approach was too abstract and that its alleged deductivism was objectionable. Advocates of casuistry, or case-based reasoning, objected to what they at least took to be the unidirectional “downward” movement from principles to cases (Arras 2017: 11). Instead, they argued for a more “bottom up” approach, which would see actual cases, rather than any one moral theory, as the starting point, and would conceive of moral principles as in fact emerging from our consideration of cases.