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In an era dominated by rapid technological change, artificial intelligence, and evolving legal frameworks, the ethical compass of healthcare professionals is being tested as never before. Faced with questions surrounding end-of-life care, consent, resource allocation, and professional integrity, the temptation is to seek wholly new paradigms to navigate uncharted waters. Yet, it is precisely at such a juncture that the past might offer more than mere historical curiosity – it might provide the moral scaffolding for our professional futures.
At a recent ethics conference, I invited colleagues to reflect not on emerging technologies or predictive algorithms, but on the enduring insights of the classical philosophers. This article is based on that presentation, tracing writings of ancient thinkers – especially Aristotle.
But let me begin with a story. A moment of personal recollection that shaped the arc of my professional and ethical journey.
I was 17, weeks from leaving school to embark on a career in dentistry. An unexpected summons came from the deputy headmaster, accompanied by a degree of formality that made me anxious. That morning, I’d been accused – unfairly, I should add – of gambling in the school common room. In truth, I’d merely been performing a card trick. Magic, not mischief, is my lifelong hobby.
As I approached the office that afternoon, I found three friends waiting, equally bewildered. We soon discovered this wasn’t about discipline. It was something far more enduring.
“I know you all intend to pursue a healthcare profession,” the deputy head began, “but I’m concerned that none of you have studied any non-science subjects.”
“You must understand,” he said gently but firmly, “that medicine and dentistry are as much about philosophy as they are about science.” These words have always remained with me, reinforced years later when I encountered a quote attributed to Edmund Pellegrino:
“Medicine is the most scientific of the humanities and the most humane of the sciences.”
Imagine, for a moment, a two-seater time machine – one seat for you, one for a classical philosopher. Whom would you choose to bring to the present to discuss today’s ethical challenges.
Would it be Socrates, with his relentless questioning and the Socratic method, urging self-knowledge as the bedrock of moral life? Or Plato, whose emphasis on ideal forms and rationality echoes the aspirations of evidence-based practice?
Perhaps Epicurus, defining pleasure as the absence of pain – a poignant parallel to palliative care’s goal of alleviating suffering.
My companion of choice is Aristotle.
Aristotle’s work, particularly the Nicomachean Ethics, offers a deeply resonant model for the moral life. In The School of Athens, Raphael's great fresco, Aristotle stands centrally with Plato, symbolising the synthesis of thought and action. In his hand, he holds the Ethics. This image hung in my clinic for 30 years – a daily reminder that virtue trumps technology.
Let us examine two Aristotelian concepts: eudaimonia, and virtue ethics. These, I propose, are the cornerstones of an ethical practice today.
The Greek word eudaimonia is often translated as happiness, but its meaning is far richer. Aristotle describes it as the highest human good: a state of flourishing, of living well, of fulfilling one’s purpose. For healthcare professionals, this raises important questions – not only about patient welfare, but about our own professional fulfilment.
In clinical contexts, we see eudaimonia reflected in the shift from purely curative models to those prioritising quality of life. Palliative care, for instance, focuses on quality of life in the end stages.
Importantly, clinician wellbeing is part of this ethical landscape. Research consistently links physician burnout with reduced patient satisfaction, increased error rates, and poorer outcomes. Happy doctors provide better care. When we cultivate our own flourishing, we serve patients more effectively.
In contrast, hedonic happiness – short-term pleasure – is fleeting. I learned this lesson at age 29, when I bought the car of my childhood dreams. The thrill vanished within six weeks. Psychologists call this hedonic adaptation: the human tendency to return to a baseline of happiness regardless of material gain.
This ‘hedonic treadmill’ traps us in cycles of acquisition. We celebrate that we have the means but are inclined to overlook the importance of meaning.
Modern medical ethics often rely on rules and principles: do no harm, respect autonomy, provide beneficence. Aristotle’s ethics ask not ‘What should I do?’ but ‘What kind of person should I be?’
Virtue ethics, encourages the cultivation of character traits – compassion, courage, integrity, and humility. These virtues are not innate; they are habits developed through practice. Aristotle wrote that we become just by doing just acts.
In an era of algorithmic medicine and AI diagnostics, this human dimension becomes ever more vital.
We need judgment, empathy, and responsibility – virtues that cannot be programmed but must be lived.
Modern bioethics owes much to Beauchamp and Childress, whose Principles of Biomedical Ethics (1979) introduced a principlist framework – autonomy, beneficence, non-maleficence, and justice – that remains foundational in medicine/dentistry and education.
What we need, I suggest, is a synthesis: a framework where principles are complemented by virtues. Where the ‘what should I do?’ of principlism is balanced by the ‘what kind of person should I be?’ of virtue ethics.
As Professor Raanan Gillon – one of the UK’s foremost voices in medical ethics – has argued, the two are not in conflict but are mutually dependent. Principles need moral character to be applied wisely. Virtues need structure to avoid becoming vague aspirations.
So where does this leave us?
It leaves us, I believe, with a sense of renewed clarity which lies in part in timeless principles articulated more than 2,000 years ago.
Eudaimonia reminds us to flourish, not merely function. Virtue ethics challenges us to embody the good, not just follow rules.
As we navigate an increasingly complex medicolegal environment, let us remember that medicine and dentistry are not only a science and a service, but also a moral endeavour. Its practice demands knowledge but also character, purpose, and wisdom.
