Flourishing at the End of Life
by Xavier Symons, John Rhee and Tyler VanderWeele, Public Discourse:
Dying is part of life, but most people dread their final days. The end of life, which often takes the form of protracted terminal illness, can involve significant pain and suffering as well as functional limits in day-to-day living. Is it still possible for human beings to flourish at the end of life?
Editors’ Note: This essay is a shortened, adapted version of a paper published in Theoretical Medicine and Bioethics on August 20. 2024. Portions of this essay were taken directly from the article, with permission from the publisher. The authors would like to acknowledge the contributions of their colleagues Anthony Tanous, and Tracy Balboni, who are co-authors on the paper.
While dying may be a time when agency and quality of life are limited, the end of life also presents unique possibilities for the realization of human goods. Some dying patients discover meaning by reflecting on the events of their lives and come to a deeper appreciation of their own life legacy. Terminal illness also presents opportunities for a deepening of close social relationships and the fulfillment of relationship commitments. Paradoxically, the end of life can be a catalyst for gratitude and self-transcendence. It is worth asking, then: can we flourish even as we approach death? And how can we help our loved ones flourish in their final days?
Human Flourishing and End-of-Life Care
Humans have long grappled with the question of what it means to flourish. According to Aristotle, flourishing is best understood as the action of a living thing in accord with its proper function. The English word flourishing has as its point of reference the vigorous development of a living thing over time. In the case of human beings, Aristotle takes this vigorous development to be constituted by rational activity in accord with virtue, given that a human being can be defined as a rational animal.
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