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