The Good

I've been delving deeper into concepts of medical ethics of late through my work at CompassCare, and we ran into this question: how do we know what is "good" for the patient at any point in the engagement between doctor and patient?

Dr. Edmund Pellegrino, widely considered the father of modern medical ethics, developed a quadripartite notion of 'the good:'

1. the medical good (what is the clinically best thing to do)
2. the patient's good (as perceived by the patient)
3. the human good (considering the whole person and human telos)
4. the spiritual good (based on the patient's and doctor's beliefs)

These are ascending concepts, such that each submits to all of those after them.

In considering this question, "what is good?" I've been considering how Dr. Pellegrino's notion (which, by the way, lines up implicitly with traditional medical ethics) could be expanded to consider all social interactions.

Notably, the doctor/patient engagement is different from typical social interactions, because all the power in the relationship is on one side. Nevertheless, there may be a similar filter:

1. the normative good (what is culturally expected or appropriate behavior)
2. the other's good (as perceived by them)
3. the human good (considering the whole person and human telos)
4. the spiritual good (based on the beliefs of the self)

Notice that there is no consideration of what is good "for me," the self, except perhaps in the meanest of the goods, the normative good. The self is considered only generally in the human and spiritual goods.

What is our process for considering actions in relationship? When we ask ourselves, "What is the next best thing for me to do in this relationship?" through what criteria do we pass our decision?

What are your thoughts?