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Gross National Happiness, Geriatrics, and Palliative Care

I saw one of my favorite philosophers speak yesterday: Peter Singer.  His book Animal Liberation is reason I became a vegetarian for 3 years...until I was an intern, post-call, hungry, and it was "rib day".  It was either a baked potato or the ribs.  The potato lost.

His current work focuses on a philosophical shift, from being a "preference utilitarian" to being a "hedonistic utilitarian."  Loosely, his interpretation of hedonism in this context is "happiness."  His talk ranged widely, from a discussion of strength of orgasm, to the movie "The Matrix," to Daniel Kahneman.  I freely admit I understood less than 25%.  But as near as I can tell, he was speaking about something that might relate in a profound way to geriatrics and palliative care.

What do we value as a society?  In the US, we tend to value the accumulation of wealth, as in the Gross Domestic Product (GDP).  Other societies have prioritized happiness.  Singer gave the example of Bhutan, a country that has developed the idea of Gross National Happiness (GNH).

What do we value in healthcare?  One of the uniting features of geriatrics and palliative care is the focus on improving quality of life.  One might quibble over the exact meaning of the terms, but promoting quality of life is generally accomplished by relieving suffering and promoting happiness, things that Singer has been concerned with throughout his career.  Other fields of medicine value improving health.  There is a subtle but important difference between these goals, just as there is a subtle but important difference between an ethical framework directed at maximizing preferences and another directed at maximizing happiness.

Can you imagine how different the US would be if we replaced the GDP with the GNH?  Or if the goal of all medical specialties was maximizing happiness and the relief of suffering?

Sometimes culture changes starts with the philosophers (at least until rib day).

by: Alex Smith

Comments

Susan Copley, Ph.D. said…
Thank you for this thoughtful blog, Alex! Bhutan's GNH includes over thirty weighted factors. Intriguing -- & challenging to assess. Fascinating to apply this framework to families, schools, & of course the practice of medicine. Geripal leads the way.
Anonymous said…
i do wish that the greed and materialsim of the majority of our population would see the light; and begin to value community, helping one another and the investment in our children, education, helping the poor and elderly.
if the US Govt can spend 10 billion dollars a month in Afghanistan, why will our congress not invest this much or more in our own people and communities: starving children in Florida, homeless in inner cities, adolescents in gangs instead of vocational training.
BIPARTISAN IGNORANCE APPEARS RAMPANT,
Dr P
SteveBrad said…
What a good blog I never thought I could get something good like this, actually I've increased my knowledge, actually I know my friends will be so happy with this when I sharing it with them.
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While you're reading, I'll just go over and lick this toad.

-@AlexSmithMD





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Transcript
Eric: Welcome to the GeriPal Podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: Alex, I spy someone in our …