Skip to main content

Advertisement

SpringerLink
Log in

Meaning and medicine: An underexplored bioethical value

Sinn und Medizin: ein neues Forschungsfeld

  • Original Article
  • Published:
Ethik in der Medizin Aims and scope Submit manuscript

Abstract

Definition of the problem

Since the origin of bioethics as a discipline, the field has been dominated by consideration of two main values, well-being and morality. I cast doubt on whether those are sufficient to resolve an array of important debates about which decisions to make in respect of medicine, and I also consider whether a third, under-explored value should play a much larger role.

Arguments

I provide reason to believe that the value of what makes a life meaningful is essential to being able to provide conclusive judgements about several contentious matters in bioethics. After first indicating how meaningfulness plausibly differs from rightness and happiness, I point out how it cannot be reasonably ignored when making decisions in six ‘life and death’ matters.

Conclusion

My aim is not to draw any firm conclusions about what to do when it comes to these life and death topics, but rather to show that in order to arrive at any, one has to consider the category of life’s meaning, which has, until recently, been nearly absent from Western bioethics since its inception.

Zusammenfassung

In diesem Artikel argumentiere ich dafür, dass einige bioethische Herausforderungen nicht angemessen im Rahmen eines traditionellen Deutungsmusters verstanden werden können, das sich allein auf die Werte Moralität und Wohlergehen stützt. Ich werde zeigen, dass für eine angemessene ethische Behandlung vielmehr insbesondere auf den Wert des sinnvollen Lebens rekurriert werden muss. Nachdem ich kurz erläutert haben werde, wie sich Sinnhaftigkeit von moralischer Richtigkeit und Glück unterscheidet, werde ich darlegen, wie sich die Sinnfrage in sechs wichtigen bioethischen Debatten stellt, und aufzeigen, dass sie nicht vernünftigerweise ignoriert werden kann. Hierbei will ich nicht die Frage nach dem richtigen Handeln innerhalb dieser Problemfelder beantworten, sondern zeigen, dass sich diese Frage nur dann angemessen beantworten lässt, wenn man die bislang vernachlässigte Kategorie des Lebenssinns berücksichtigt.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. The gap would be traversed if it were the case that, say, the word ‘moral’ by definition meant the most weighty considerations for or against an action. However, contemporary philosophers have demonstrated that this is not what the word ‘moral’ means. If talk of ‘right’ and even ‘morally required’ by definition connoted the most important reasons, then it would be logically contradictory to pose the question of whether one ought to do what is right or morally required. However, even if one in fact ought to do what is right or required, it is not incoherent to wonder whether one should. An ‘amoralist’, one who asks whether one should live a moral life, is intelligible and is not speaking nonsense. See Brink (1989, pp. 46–50, 59, 84).

  2. Consider that, according to GoogleScholar, this book has been cited about 30,000 times at the time of writing this article.

  3. Some might accept that there is a category of meaning but deny that it is something that makes a life more desirable. For the purposes of this article, advancing that position is welcome—doing so is consistent with the basic point that bioethicists and the like need to engage in systematic debate about the nature and worth of meaning.

  4. The following point is cribbed from Metz (2015, pp. 120–121).

  5. See related debate about whether genetically modifying non-human organisms would also undercut meaning in, eg, van den Belt (2009).

  6. For discussion of some of the complex relationships between meaning and morality, see Kipke and Rüther (2019).

  7. For overviews of recent English-speaking philosophical literature on life’s meaning, see Metz (2021); Seachris (2021). For the most comprehensive anthologies of such literature, see Seachris (2013b); Klemke and Cahn (2018).

References

  • Agar N (2013) Humanity’s end: why we should reject radical enhancement. MIT Press, Cambridge

    Google Scholar 

  • Beauchamp T, Childress J (1979) Principles of biomedical ethics, 1st edn. Oxford University Press, New York

    Google Scholar 

  • van den Belt H (2009) Playing God in Frankenstein’s footsteps: synthetic biology and the meaning of life. Nanoethics 3:257–268

    Article  PubMed  PubMed Central  Google Scholar 

  • Bourgeois S, Johnson A (2004) Preparing for dying: meaningful practices in palliative care. Omega 49:99–107

    Article  Google Scholar 

  • Bowie NE (1998) A Kantian theory of meaningful work. J Bus Ethics 17:1083–1092

    Article  Google Scholar 

  • Bowman KW, Martin DK, Singer PA (2000) Quality end-of-life care. J Eval Clin Pract 6:51–56

    Article  CAS  PubMed  Google Scholar 

  • Brink D (1989) Moral realism and the foundations of ethics. Cambridge University Press, Cambridge

    Book  Google Scholar 

  • Campbell S, Nyholm S (2015) Anti-meaning and why it matters. J Am Philos Assoc 1:694–711

    Article  Google Scholar 

  • Danaher J (2014) Hyperagency and the good life—Does extreme enhancement threaten meaning? Neuroethics 7:227–242

    Article  Google Scholar 

  • David M, Kirkhope J (2005) Cloning/stem cells and the meaning of life. Curr Sociol 53:367–381

    Article  Google Scholar 

  • Diehl U (2009) Human suffering as a challenge for the meaning of life. Existenz 4:36–44

    Google Scholar 

  • Dwyer L‑L, Nordenfelt L, Ternestedt B‑M (2008) Three nursing home residents speak about meaning at the end of life. Nurs Ethics 15:97–109

    Article  PubMed  Google Scholar 

  • Ettema E, Derksen L, van Leeuwen E (2010) Existential loneliness and end-of-life care: a systematic review. Theor Med Bioeth 31:141–169

    Article  PubMed  PubMed Central  Google Scholar 

  • Ferracioli L (2018) Procreative-parenting, love’s reasons, and the demands of morality. Philos Q 68:77–97

    Article  Google Scholar 

  • Gems D (2003) Is more life always better? The new biology of aging and the meaning of life. Hastings Cent Rep 33:31–39

    Article  PubMed  Google Scholar 

  • Glaw X, Kable A, Hazelton M, Inder K (2017) Meaning in life and meaning of life in mental health care: an integrative literature review. Issues Ment Health Nurs 38:243–252

    PubMed  Google Scholar 

  • Harris J (2003) Consent and end of life decisions. J Med Ethics 29:10–15

    Article  PubMed  PubMed Central  Google Scholar 

  • Harris J (2007) Enhancing evolution: the ethical case for making better people. Princeton University Press, Princeton

    Google Scholar 

  • Häyry M (2011) Considerable life extension and three views on the meaning of life. Camb Q Healthc Ethics 20:21–29

    Article  PubMed  PubMed Central  Google Scholar 

  • Hester DM (1998) Progressive dying: meaningful acts of euthanasia and assisted suicide. J Med Humanit 19:279–298

    Article  Google Scholar 

  • Heyd D (1984) The meaning of life and the right to voluntary euthanasia. In: Carmi A (ed) Euthanasia. Springer, Berlin, pp 169–174

    Chapter  Google Scholar 

  • Kamm FM (2013) Bioethical prescriptions: to create, end, choose, and improve lives. Oxford University Press, New York

    Book  Google Scholar 

  • Kass L (2002) The meaning of life—in the laboratory. Public Interest 146:38–73

    Google Scholar 

  • Kauppinen A (2014) Flourishing and finitude. J Ethics Soc Philos http://www.jesp.org/articles/download/flourishing-and-finitude.pdf. Accessed: 7 Aug 2021

  • Keat R (2009) Anti-perfectionism, market economies and the right to meaningful work. Anal Krit 31:121–138

    Article  Google Scholar 

  • King L, Hicks J (2021) The science of meaning in life. Annu Rev Psychol 72:561–584

    Article  PubMed  Google Scholar 

  • Kipke R, Rüther M (2019) Meaning and morality: some considerations on a difficult relation. Soc Theory Pract 45:225–247

    Article  Google Scholar 

  • Klemke ED, Cahn SM (eds) (2018) The meaning of life: a reader, 4th edn. Oxford University Press, New York

    Google Scholar 

  • Kluge E‑H (2009) Quality-of-life considerations in substitute decision-making for severely disabled neonates. Theor Med Bioeth 30:351–366

    Article  PubMed  Google Scholar 

  • Kohl M (1978) Voluntary death and meaningless existence. In: Kohl M (ed) Infanticide and the value of life. Prometheus, Buffalo, pp 206–218

    Google Scholar 

  • Little M (1999) Assisted suicide, suffering and the meaning of a life. Theor Med Bioeth 20:287–298

    Article  CAS  PubMed  Google Scholar 

  • Martela F, Steger M (2016) The three meanings of meaning in life: distinguishing coherence, purpose, and significance. J Posit Psychol 11:531–545

    Article  Google Scholar 

  • Mawson TJ (2016) God and the meanings of life. Bloomsbury, London

    Google Scholar 

  • Messerly J (2013) The meaning of life: religious, philosophical, transhumanist, and scientific perspectives. Darwin & Hume, Seattle

    Google Scholar 

  • Metz T (2013) Meaning in life: an analytic study. Oxford University Press, Oxford

    Book  Google Scholar 

  • Metz T (2015) Fundamental conditions of human existence as the ground of life’s meaning. Relig Stud 51:111–123

    Article  Google Scholar 

  • Metz T (2016) Reasons of meaning to abhor the end of the human race. Faith Philos 33:358–369

    Article  Google Scholar 

  • Metz T (2019) God, soul and the meaning of life. Cambridge University Press, Cambridge

    Book  Google Scholar 

  • Metz T (2021) The meaning of life. In: Zalta E (ed) Stanford encyclopedia of philosophy https://plato.stanford.edu/entries/life-meaning/. Accessed: 7 Aug 2021

  • Miller BJ, Berger S (2019) A beginner’s guide to the end: practical advice for living life and facing death. Simon & Schuster, New York

    Google Scholar 

  • Moreno-Milan B, Cano-Vindel A, Lopez-Dóriga P, Medrano L, Breitbart W (2019) Meaning of work and personal protective factors among palliative care professionals. Palliat Support Care 17:381–387

    Article  PubMed  PubMed Central  Google Scholar 

  • Nozick R (1974) Anarchy, state, and utopia. Blackwell, Oxford (Repr. 1999)

    Google Scholar 

  • Nussbaum M (1989) Mortal immortals. Philos Phenomenol Res 50:303–351

    Article  Google Scholar 

  • Orr R, Genesen L (1997) Requests for ‘inappropriate’ treatment based on religious beliefs. J Med Ethics 23:143–147

    Article  Google Scholar 

  • Pijnenburg M, Leget C (2007) Who wants to live forever? Three arguments against extending the human lifespan. J Med Ethics 33:585–587

    Article  PubMed  PubMed Central  Google Scholar 

  • President’s Council on Bioethics (2003) Beyond therapy: biotechnology and the pursuit of happiness. The President’s Council on Bioethics, Washington DC

  • Quintin J (2013) Organ transplantation and meaning of life. Med Health Care Philos 16:565–574

    Article  PubMed  Google Scholar 

  • Richards D (1981) Constitutional privacy, the right to die and the meaning of life. William Mary Law Rev 22:327–419

    PubMed  Google Scholar 

  • Sandberg A (2014) Transhumanism and the meaning of life. In: Mercer C, Trothen T (eds) Religion and transhumanism: the unknown future of human enhancement. Praeger, Westport, pp 3–22

    Google Scholar 

  • Scheffler S (2013) Death and the afterlife. In: Kolodny N (ed) Death and the afterlife. Oxford University Press, Oxford, pp 15–110

    Chapter  Google Scholar 

  • Scher S, Kozlowska K (2018) Rethinking health care ethics. Palgrave Macmillan, Singapore

    Book  Google Scholar 

  • Seachris J (2013a) General introduction. In: Seachris J (ed) Exploring the meaning of life: an anthology and guide. Wiley-Blackwell, Malden, pp 1–20

    Google Scholar 

  • Seachris J (ed) (2013b) Exploring the meaning of life: an anthology and guide. Wiley-Blackwell, Malden

    Google Scholar 

  • Seachris J (2021) Meaning of life: the analytic perspective. In: Fieser J, Dowden B (eds) Internet encyclopedia of philosophy https://iep.utm.edu/mean-ana/. Accessed: 17 September 2021

  • Sinclair S (2011) Impact of death and dying on the personal lives and practices of palliative and hospice care professionals. Can Med Assoc J 183:180–187

    Article  Google Scholar 

  • Taubman-Ben-Ari O, Weintroub A (2008) Meaning in life and personal growth among pediatric physicians and nurses. Death Stud 32:621–645

    Article  PubMed  Google Scholar 

  • Thomson G (2003) On the meaning of life. Wadsworth, South Melbourne

    Google Scholar 

  • Trisel BA (2004) Human extinction and the value of our efforts. Philos Forum 35:371–391

    Article  Google Scholar 

  • Varelius J (2013) Ending life, morality, and meaning. Ethical Theory Moral Pract 16:559–574

    Article  Google Scholar 

  • Wilkinson D (2011) A life worth giving? The threshold for permissible withdrawal of life support from disabled newborn infants. Am J Bioeth 11:20–32

    Article  PubMed  PubMed Central  Google Scholar 

  • Wolf S (2007) The meanings of lives. In: Perry J et al (ed) Introduction to philosophy, 4th edn. Oxford University Press, New York, pp 62–73

    Google Scholar 

  • Wolf S (2010) Meaning in life and why it matters. Princeton University Press, Princeton

    Book  Google Scholar 

  • Wolf S (2016) Meaningfulness: a third dimension of the good life. Found Sci 21:253–269

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Philosophy, 20-10 Humanities Building, University of Pretoria, Private Bag X20, Hatfield, 0028, Pretoria, South Africa

    Thaddeus Metz

Authors
  1. Thaddeus Metz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thaddeus Metz.

Ethics declarations

Conflict of interest

T. Metz declares that he has no competing interests.

Ethical standards

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

Additional information

This article is a substantially revised and expanded version of Metz T (2016) Life, meaning of. In: Ten Have H (ed) Encyclopedia of global bioethics. Springer, Cham, pp. 1–6, https://doi.org/10.1007/978-3-319-09483-0_267, published under CC BY-NC-ND 4.0 license. Reprinted with permission from Springer.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Metz, T. Meaning and medicine: An underexplored bioethical value. Ethik Med 33, 439–453 (2021). https://doi.org/10.1007/s00481-021-00662-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00481-021-00662-x

Keywords

Schlüsselwörter

Search

Navigation