Centering dignity as the ultimate goal of health | The Healthiest Goldfish

Reframing our engagement with a universal human value.

In 2021, I wrote a Viewpoint for JAMA Health Forum arguing that elevating dignity should be a central goal for our pursuit of health in the COVID-19 era and beyond. Most of those who work in the health space would likely say that we value dignity, but it struck me that few have articulated the importance of dignity as an organizing principle for all we do, one which can help guide our efforts in the complexity of this moment. Since writing that piece, I have continued to think about the role of dignity as a core value for our work. In many ways, dignity, despite its importance, remains under-discussed in the health conversation. There have been only a handful of academic articles which have discussed dignity in health, and these tend to focus on patient dignity in healthcare rather than dignity in the broader context of health—as in, for example, Francis Peabody’s classic 1927 article, “The Care of the Patient.” While this article does not actually use the word “dignity,” it in many ways started the conversation about dignity in healthcare by advising clinicians to keep always in view the individual identity of patients, rather than see them as faceless, interchangeable problems to be solved.

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The Real Reward | Observing Science

It is rare for scientists to become famous. For some, fame came when they captured the zeitgeist with their ideas. For example, Heisenberg’s “uncertainty principle” resonated in an age of psychological uncertainty. For others, it is work that is ancillary to their actual science that brings fame. Robert Oppenheimer was a public figure less for his scientific work on the structure of subatomic particles than for leading the Manhattan Project and the development of the atom bomb during war time. Watson and Crick became famous not only for describing the chemical basis of heredity—beginning a biological revolution—but also for delivering a beautiful, odd, unfamiliar term in science, double helix—the structure of DNA—to a wider audience.

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Speaking Out | Observing Science

“Is it enough to do good science and publish it in reputable peer-reviewed journals?” asks historian of science Naomi Oreskes.

A resume filled with peer-reviewed publications and presentations at scientific meetings is the standard scientific career. And yet, more and more scientists are finding themselves translating a piece of their work for a larger audience. There are scientists who enter fields that they know are more public—those who study climate science or gun violence or the outcomes of child poverty—and who, as such, can expect to be called upon to engage in the public space. But the spread of misinformation calls on the engagement of scientists of all stripes from time to time. What does a scientist do, in the performance of her research, when she feels the needs to speak out on an issue on which she is an expert, pushing beyond peer review into public view?

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The Pump Handle | Observing Science

Accumulated knowledge can be passed from one generation to the next. And so it is possible to pass on mistaken ideas, even ones that are harmful.

It’s worth retelling the story of the Broad Street epidemic of 1854 London to remind ourselves how difficult it is to change scientific dogma. Cholera, “whatever it was, or wherever it had come from,” as Steven Johnson described in The Ghost Map, arrived with a shattering velocity around Broad Street. Entire families died in a single night, hundreds of residents living in a five-block London neighborhood died over a few days. This outbreak attracted medical detectives because it followed a severe and more widespread cholera outbreak six years earlier that had killed 50,000 Londoners and made this problem a pressing medical mystery.

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Generating Science That Informs Decision-Making | Observing Science

Should science aspire to be useful? That is a deceptively simple question. It is often assumed that the fundamental role of science is to contribute to the improvement of the human condition. University marketing brochures make note of the practical utility of the work of their scientists. And yet, it is not so simple. 

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What To Do When Science Gets It Wrong | Observing Science

In February 1953, one of the world’s pre-eminent scientists, Linus Pauling (who went on to win two Nobel Prizes) published, with Robert Corey, a paper in the Proceedings of the National Academy of Sciences called “A proposed structure for nucleic acids,” suggesting a triple helix as the foundation for what we now call DNA. He was, of course, wrong. 

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Juneteenth, and the history that shapes our health | The Healthiest Goldfish

Reckoning with the past, to shape a healthier future.

These essays aim to tackle what is most fundamental to the pursuit of health. Centrally, this means addressing ideas, recognizing that all we do in pursuit of health fundamentally starts with the ideas we embrace. However, these ideas are shaped by a broad range of forces, including, perhaps centrally, our history. Our history shapes our health. Where we come from, our family circumstances, our access to education and safe neighborhoods, the conditions of our past all influence our health in the present.

Just as we have a history as individuals, we also have a past collectively, as members of a society, as citizens of a country. Just as our past as individuals profoundly affects our health in the present, our health as a people cannot be understood without consideration of our common history. Our present is shaped by a range of intersecting legacies. These include the legacies of various philosophical systems, such as the Enlightenment, the legacies of wars, of colonialism, of technological progress, of movements for social justice.

And, in the US, they include—centrally, tragically—the legacy of slavery.

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The obligation for humility and compassion | The Healthiest Goldfish

The values at the heart of our work in health

In this series of Healthiest Goldfish essays, which started more or less at the beginning of 2023, I have been aiming to articulate a practical philosophy of health. In so doing, I have intermittently mentioned the importance of humility and compassion as values that should inform what we do and how we do it. However, I have never focused on the former as a central thought in a full essay. I thought I would do so here, coupled with compassion, which I think emerges from the former.

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