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Flourishing / Medicine

Lydia Dugdale

Dorothy L. and Daniel H. Silberberg Associate Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons
Director of the Center for Clinical Medical Ethics


This brief describes well how medicine has gone astray: "experts in means but amateurs in ends.” We doctors have come to focus far too much on patients feeling well, while ignoring both society's responsibility in ameliorating adverse circumstances (see Bradley & Taylor's The American Health Care Paradox) and patients' agency in caring for themselves. No wonder patients don't flourish.

Having said this, there's still part of me inclined toward a Stoic sense of eudaimonia that holds that one can flourish through the cultivation of a life of virtue despite feelings and circumstances. I'm partial toward this view because I have experienced flourishing (of self and others) in the face of great adversity. Perhaps it constitutes a second-rate, heavily qualified form of flourishing. But to say that flourishing is impossible when, for example, a patient is sick or dying, is to settle for too narrow a view of human flourishing.