Buscar en
Boletín Médico del Hospital Infantil de México (English Edition)
Toda la web
Inicio Boletín Médico del Hospital Infantil de México (English Edition) To live well: health care or life project? Part II
Journal Information
Vol. 73. Issue 4.
Pages 283-290 (July - August 2016)
Visits
487
Vol. 73. Issue 4.
Pages 283-290 (July - August 2016)
Public Health
DOI: 10.1016/j.bmhime.2016.01.002
Open Access
To live well: health care or life project? Part II
El bien vivir: ¿cuidado de la salud o proyecto vital? Segunda parte
Visits
...
Leonardo Viniegra-Velázquez
Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Abstract

On the basis that life project is the driving force behind the life experience, the quest for human dignity is the way for real progress and the improvement of human condition. The need to be aware of the meaning of life is pointed out, understanding the motives behind our will to live, which are the antecedent of a life project.

The proposed life project is a cognitive adventure, capable of transcending consumerism, individualism and passivity, toward the creation of a more inclusive world where the human dignity has a viable improvement in a spiritual, intellectual and moral way.

This life project entails a primary need: to link oneself with like-minded people that synergize against the prevailing order; a core, the everlasting struggle for sublimated dignity; a desideratum, the well-being of the majority; and an unavoidable purpose, the creation of a suitable world build on different ethical, political, lawful, cognitive and ecological foundations.

In conclusion, this paper analyzes the influence of projects with an alternate proposal to the endeavors centered in health care that favor individualism, passivity and the current status quo. The best example of the mentioned alternative plans is the commonly called “good death”.

Keywords:
Meaning of life
Life project
Life experience
Dignity
Individualism
Social passivity
Good death
Resumen

El sentido de la vida, la razón profunda del anhelo de vivir y la motivación para actuar en consecuencia, es el antecedente del proyecto vital. Se argumenta cómo la lucha por la dignidad es el verdadero derrotero de superación de la condición humana y el eje de proyecto vital que aspiran al bien vivir.

El proyecto vital que se propone es una aventura cognitiva que trasciende el consumismo, el individualismo y la pasividad en la búsqueda de otro mundo hospitalario e incluyente, donde tenga viabilidad la superación espiritual, intelectual y moral de la dignidad humana. Este proyecto vital entraña una necesidad primaria: vincularse con otras subjetividades afines; un núcleo: la lucha incesante por la dignidad sublimada; un desiderátum: el bien vivir de las mayorías; y un propósito indeclinable: la edificación sobre otros basamentos éticos, políticos, jurídicos, cognitivos y ecológicos, de un mundo propicio para el bien vivir.

Se arguye acerca de la superioridad de proyectos vitales altruistas en la consecución del bien vivir comunitario, sobre los afanes centrados en la preservación y el cuidado de la salud que favorecen el individualismo, la pasividad y el statu quo. La búsqueda del “bien morir” es el mejor ejemplo de la influencia benéfica de este tipo de proyectos en el cuidado de la salud.

Palabras clave:
Sentido de la vida
Proyecto vital
Experiencia vital
Dignidad
Individualismo
Pasividad social
Bien morir
Full Text

“...I think that old age is a good age to

fight for human dignity.... like any other.

Bertrand Russell

1Introduction

The meaning of life (ML) concerns the profound and intimate motives that generate the desire to live in a certain way and the motivation to act accordingly. Some examples are starting a family, loved ones, passion for knowledge, job satisfaction, the pursuit of goals, religion, fighting for certain ideals and values, or helping those who are in need. Some of these or other reasons are the underlying cause for the touching and admirable strength of some adults to overcome adversity, persevere in “the impossible”, perform “the unattainable”, or beat “the impossible”, which reflect vigorous life projects. At present, using individualism as a life philosophy and its counterpart: “every man for himself” in the middle of a wide social decomposition, ML usually is related to family ties and commitments, which imply tacit vital projects aimed, for example, to self-reliance, a safe and gainful job, recreational activities, or health, whose realization is getting increasingly inaccessible for most of the population.

Alluding the point of view of an acute thinker and activist who considers the “struggle for human decency” on all possible fronts, the vital priority par excellence at any age.1 This maxim, as opposed to individualism, reveals ways of thinking and acting of a reality-enlightened conscience of the world and the roots of human problems, aimed at the defense of dignity as the objective of this philosopher, who enlightened his time. Also, with this judgment and his biography, we infer the ML for this deliberative character: the passion for knowledge, where he caught the subjective interdependence in achieving a better world. He recognized dignity as the highest and universal value involved in the growth of the human condition, and he struggled for its preservation as the primary goal of his life (life project).

The life project (LP) is understood as an “evaluative perspective of the personal experience that articulates and orients the decisions, actions and plans for achieving objectives and fulfilling meaningful life purposes.” Currently, hoping for a world where living well and having a compelling personal LP requires—quoting Russell—involvement in the struggle for human dignity.1 This fight, given the intricate problems that humanity suffers—which common denominator is threatening, impairing, or nullifying (usually in a subtle manner) the most elemental dignity—merits a new meaning to recognize and deal with the degrading effects of greediness without limits, with the individualism and with passivity, which numbs us about the generalized debasement that affects everyone (in different forms and extents) and, therefore, is incumbent on all of us.

The idea is to reframe the struggle for dignity beyond its current connotation that downgrades it to the frivolous and individualistic, identifying progressive levels, as phases of a cognitive, collective, and endless process:

  • a)

    The first step would be strengthening values involved in the spiritual, intellectual, and moral improvement of the human condition; this is the level of depth and altruistic dignity

  • b)

    The pursuit of such dignity in exercising new forms of liberty, approaching to higher modes of coexistence integrating horizontal organizations with prominent ties of cooperation, synergy, and solidarity, where individual participation leads to collective self-management of the chosen conditions and circumstances of life; it represents the next level of the freed and self-determined dignity

  • c)

    These LP together, handlers of life's terms and circumstances, would not be so without a clear awareness of the overall life process, as a matrix which generates all life forms—including the human—in its permanence and evolution2,3; this consciousness implies an appreciation of life as a whole; the struggle for dignity is widespread to other forms of life, as unswerving moral responsibility to care for and preserve our common home. This is the enlightened dignity level

  • d)

    In this course, LP would generate community-based life forms founded on unusual ways of interaction: collaborative, constructive, satisfactory, deliberative, challenging, and in harmonious with the earth's ecosystem, leading to a higher level: sublimated dignity (SD), which emphasizes the evaluative as the peak of the cognitive adventure, including cognitive attributes of previous levels

To prioritize the fight for SD, in its connotation of genuine human progress, may be judged as esoteric, exorbitant, distant, and even foreign as the core of the ML and course of the individual LP. However, the present times are a testimony of the terrible consequences that the prevalence of internalized dominant ideas (individualism, passivity) have, which embody in life reasons circumscribed in a broad spectrum of self-centered alternatives. In one end, the search for “good business” and its privileges by a minority corrupted by greed, and in the other end, the mere day-by-day survival, consuming the disadvantaged, marginalized, or excluded vitality. Between these extremes, seeking the individual dignity is an illusion because it is impossible to do so outside the community. It is evident that any attack on the dignity of individuals, communities, or ethnic groups is evidence of the vulnerability, permissiveness and complicity of the powers that govern the planet, and that respect for human dignity of other communities, regions or cultures is more superficial than real (discretionary justice for the “allies and partners” of the hegemonic power) and in any case, circumstantial (while remaining as such, on the “right side of history”), not a universal principle of coexistence. It is not intended to belittle the struggle for individual dignity when it goes beyond “adapting” or when it comes apart from the alienating consumerism; the problem is that it represents an impediment to progress towards the collective and communal (individualism is one of the biggest obstacles to genuine progress). The struggle for dignity cannot prosper outside organizations that share real interests, committed to the defense of their dignity and the dignity of vulnerable groups such as native people, the disabled, the poor, children, or the patient; operating in: family, school, work, courts, etcetera, where members can fight with some effectiveness against injustice and inequality.

2Live in dignity

Placing SD in the core of the LP during these difficult moments in history forces us to reflect on its implications and possibilities. Initially, it must be recognized that respect, in its various forms, is the spirit of dignity since it was conceived as one of the existence principal values. Respect can be found: towards oneself (expressed in the characteristics of self-esteem), received from others and granted towards others.4 Respect is shown in two different ways: restricted to certain people or groups, or as a general principle (attitude) of interaction and coexistence with others (reciprocity). The latter case implies mutual recognition of equal rights and obligations. Considering how racism and discrimination prevail in nowadays cultures, it is clear that the form of respect which has prevailed throughout the social interactions has a particular connotation, and therefore a discriminatory one. In this case, those worthy of respect (often a simulation) are the close ones, the wealthy ones, those of a high social hierarchy or “good manners”. The other form of respect, shown as a principle of coexistence that considers equal rights without exception, is in fact, a marked minority, and an elitist education that is backed up by an accentuated social polarization; it is considered a drawback, or it is ignored. Such situation is not coincidental in a world shaped by inequality, abuse, individualism, and competition, which are notable conditions and forms of interaction between people, groups, and social divisions. The struggle for collective dignity in its connotation of living well, based on respect for a principle of intercommunication and coexistence, faces enormous obstacles to move forward. In an unequal world that cracks, which does not stop the constant emergence of diverse organizations defending human rights and promote laws that strengthen them.5 If these organizations are carriers of genuine interest and not only a lure for good business, they could only prosper with determination and commitment escorted by development and maturation of other attributes and qualities that generate strong interpersonal relationships like empathy, generosity, reciprocity, honesty or perseverance (antidotes of the current simulation). These features enrich the dignity and cohesion of the group, establishing friendly ties within peers and solidarity with the different, and by this, it contributes coping with the enormous obstacles that separate them from their purpose. However, the sine qua non for the pursuit of real collective dignity is the search for knowledge that leads to an enlightened and critical consciousness about oneself and the prevailing order. In other words, the struggle for dignity is not spontaneous, it is the arrival point for other education strategies (critique based), as a shared knowledge adventure, learning to recognize, prioritize and act according to the judged as the greater of the human condition. It reveals a habituated awareness to the reflective introspection, which questions (supporting base of authentic criticism) beliefs and alleged unquestionable truths that prevail in the different areas of collective teaching experience.6 When this cognitive search becomes a vital imperative for the partakers, it rearranges and resizes life priorities finding its place in this permanent effort.

The cognitive adventure that means the struggle for collective dignity matches in this essay to a kind of life force that animates the good life, it is not something innate or intrinsic, but an incidental result (rare in the current circumstances) that summarizes internalized early childhood experiences, raises during interactions in different environments: family, school, work or social life. When the knowledge of oneself and its context deepens through criticism, determination to fight for their dignity (own and others) it is a result of the pursuit that extends from the self to family and friends, and depending on its vigor spans to other groups that share interests and aspirations. In this direction, when groups are increasing in size, cohesion and scope slowly find affinities diversifying, at the same time their chances increase. On this particular profession contrast, those which their core is the interaction with subjectivity like teachers or health professionals, where each professional has the formal or idealized social duty to help, meet, interpret feelings and circumstances, comfort, encourage, educate, directing or guiding students and patients, as appropriate. Meaning that, under such circumstances, these activities might be the most favorable, within the various social tasks, to fight for the SD on a big scale promoting people involvement on concerning vital issues in the management of their own life. Nevertheless, the dominating system conditions them to operate as a means of social control that favor manipulation, passivity, individualism and even degradation (with many notable exceptions and countless nuances), almost always against the genuine wishes of the “sponsors”. Educational and health institutions far from being the forefront of collective dignity sublimation, contribute decisively to the maintenance of their status quo.

The defense of collective dignity can be undertaken, of course, from very diverse spaces and “trenches”; succeeding without being victim of a miragea requires the awareness to sensitize others by the means of criticism and enlightenment, in order to bond and associate forming groups that perform similar tasks and later diverse, structured in the long run, networks which in turn lead to vigorous organizations to integrate systematized communities against the prevailing order. These communities, reaching some maturity, would interconnect in virtue of their mutual, convergent, and cooperative interests. It could be a genuine hope for a better world, founded on other spiritual, moral, intellectual and coexistent bases. Such organizations would be unviable without the active and increasing participation of its members, to confer an unprecedented cognitive force context transforming7; and a horizontal, flexible and versatile structure, which favors qualities such as initiative, creativity or wit.

3Meaning of life and the vital experience

ML that makes our existence worth living, give us satisfaction, inspire us or infuse vigor on us to act and overcome, is the result of our construction result of the interaction with objects in the environments where we developed. For most people, ML is something unspoken and apart from introspection and reflection. Form its origin the ML is shaped by the primal experiences in different areas, although the most influential are usually family. To understand how daily experience influences the ways of being and the way we appreciate life, it is necessary to distinguish between countless moments of our existence where experiences are intense and “loaded” with affective meaning (positive or negative), which leave a mark to whom experiences them and designate the quality of the links with the interacting objectsb. These experiences together are called life experience (LE).8 Specifically, LE is constituted by the network of links with specific objects with intense affective meaning. Every human, for its uniqueness, interacts with the environment in a peculiar way and establish ties with or significant objects.9 The early onset of oneself and others consciousness is decisive in the modes of interaction and the quality of the links because connections with a very significant object appear: oneself, which will have a decisive influence among the connection with the rest of the objects.10

The core of the LE (the links with the most affective significance), contrary to what is expected, is the relationship with oneself, with its multiplicity of favorable and unfavorable feelings. The first conflict is with oneself (this usually unconscious).11 How each person perceives and values himself is a consequence of the kind and quality of experiences lived and internalized while interacting with his family and social environment: ranks of acceptance or rejection, appreciation or dislike, holding or detachment, satisfaction or frustration, security or insecurity, and its related links that are mainly evaluative and from a conflictive nature because of the different combinations of the significant and insignificant, the desirable or undesirable self-perceived by the personality and corporeality in the distinct fields of manifestation: spiritual, intellectual, moral, sentimental, the related to sensuality and tastes, attitude, physical, sexual and erotic. This way, LE It is a changing constellation of experiences derived from the particular and changing link network, shaping and updating: our loves and hates, inclinations and aversions, desires and rejections, satisfactions and frustrations, trusts and distrusts, likes and dislikes, eccentricities, fear, guilt, concerns or aspirations.

It is precisely the characteristic of the disputing links with oneself to escape from consciousness allowing its projection on external objects.12 Furthermore, the exclusion of consciousness explains its decisive influence on the quality of the links that interacted with the objects (we ignore that they are projections of our conflicts). As a general trend, we appreciate, prefer, accept or enjoy what embodies or materializes a higher or desired value or according to “our internal scale”, or operating as compensation for what is experienced as weakness or what we despise (devalue) of ourselves. Conversely, we turn away, dislike, condemn, reject or suffer what we underestimate of ourselves, or what shows our weaknesses and limitations (often unconsciously).

ML and LP (usually unspoken) manifested in the way of acting have their seed in the characteristics of the early LE, governed by the relationship with oneself, meaning an introspection and self-appraisal involving several levels of acceptance and rejection which derive the characteristics of self-esteem and self-affirmation. The way of interaction with the significant objects in the different environments in which the LE unfolds depends principally on the features of the ML and the LP. To overcome difficult moments, goal hunt or in the realization pursuit, motivational strength and confidence are often decisive. A fundamental aspect of LE in our culture is that it is still hidden or ignored as an auto-contemplation object. This means that what affects the most and would benefit self-understanding is not a cause for examination and inquiry promoted by the school, the great denier. Because of this situation, ML remains blurred by not being a prominent cause for reflection, dialogue, discussion and debate for the vast majority. This culturally determined omission is the most powerful conscience control mechanism by promoting individualism as a life philosophy and empiricist reductionism as an idea that governs science.13 While the LE remains in the cognitive darkness, the passion for self-knowledge and its context cannot inspire the collective ML, and it would be difficult for an LP centered in the struggle for SD to emerge, the roots for the genuine human progress.

It is understood from the above that there is significant variability for the ML, as it originates from the LE. However, in the presence of “individualist and passive atmospheres”, where the LE is not the cause of contemplation and inquiry, it is understood that this diversity is given far within alternatives that are characteristic of the individualism and passivity, which represent the most common form nowadays. Correspondingly exiguous are altruistic options, while genuine interest and priority for “others” manifest in social commitment for the oppressed, excluded or disadvantaged, resulting in organizations committed to the defense of the rights of the disadvantaged ancestrally ignored or broken. Most LP are tacit and rarely transcend the closest affections, so it often ignores what happens beyond their LE, used to think and act in the near, immediate, and urgent, not realizing that events that shake the established order are not unimportant matters but reveal the effects of an ongoing civilization bankruptcy that drag and concerns everyone.

4Vital project and health care

The struggle for SD is opposite to the flow of events in our time, not only because individualism and passivity have internalized in the early LE (exception are indigenous communities that preserve their traditions in different regions of the planet), also because in many cases, peoples internal conflicts (the ambivalent relationship with oneself), that happen outside to conscience and not being subject of contemplation remain dormant, unresolved, disturbing, exhausting the vitality and motivation to engage in an intense, fraternal and collaborative manner outside the inner circle, and involve with collective tasks and altruistic ideals by helping the disadvantaged. That is, if dignity deserves rescue, it is unfeasible fighting for the dignity of others; however, we all have our conflict with ourselves in different degrees. Hence, those who say beyond simulation not having the slightest internal conflict, what are actually saying is that their introspection and self-criticism are clearly absent. Therefore, the objective is not to solve our conflicts before aspiring the good life. We find an apparent paradox in this matter: the internal conflicts that do not become paralyzing and gravely disturbing, marked by individualism, competitiveness and misery (distrust, anxiety, indifference, discrimination, abuse or neglect), to arrive at a consciousness on its way to enlightenment, can be endured, ameliorate, and eventually overcome not through greater self-absorption, but through other deliberate interactions, although completely different environments of respect, trust, collaboration, fraternity and solidarity, where correlative links are created and, when interiorized, modify the configuration of subjectivity towards more stable, constructive and serene attitudinal and affective states. In fact, “an effective psychotherapy” in these cases is centered in a positive and progressive change in the linking attributes with the people with whom we live and work (respect, empathy, sympathy, reciprocity, brotherhood or generosity).

Social passivity in conjunction with individualism manifests when no action comes after appreciating how alien survival problems that threaten dignity of “others”, even when affecting whole communities, large sections of the population or even people relatively close while there is not directly harm the personal interests. They are the main “accomplices” of the order that normalizes the all-embracing degradation of the human condition and make us used to this catastrophic situation, hidden or made up using persuasion, which, therefore, is not perceived as such. This explains why the existence of deliberated LP beyond individualism, are usually an exception in the present world. It also allows to understand the growing need for individuals and groups to involve in confessional or secular sectarian organizations (the “isms”) in search for identity and meaning; to adopt “the religion” of consumerism (real or illusory) and medicalization, or integrating into groups that appeal to evasion (use of licit and illicit drugs) or transgression at different levels, all of which favors the permanence of the prevailing political-economical order.

If the present situation does not show the occurrence of a severe economic crisis, but a civilization bankruptcy that denies human dignity and nullifies any possibilities of a good life for the future generations. It is a duty for those aware of the catastrophe to assume an ethical responsibility and fight for dignity. Furthermore, for a world established over other cognitive, moral, social, political, economic and ecological premises, promoting good living is everyone's aspiration and a universal right (absent in current legislation), not exclusive for minorities. Strive for good life is what gives real meaning to existence; the development of individual and collective strategies to achieve it embodies vigorous and genuinely human LP.

The LP based on knowledge adventures on the struggle for collective dignity, overcoming passivity, develop more vigor and determination while overcoming adversity, rethinking life priorities, maintain the desire for the search of new paths or to engage with other ideals and values. It is within this kind of LP that health care can acquire a true meaning, not as a life priority core, but as an ethical and unavoidable imperative with oneself guided by altruism: preserve and prolong vitality, vigor and faculties until possible (not an obsession with longevity at any cost), which persevere in one endless struggle that aspires to an inclusive, plural, equal and ecosystem caring world, which implicates spiritual, intellectual and moral growth of the human conditionc. When caring for oneself health is part of the altruist LP (apart from individualism), it is difficult for medicalization to influence the being of the person because the desire of being healthy is secondary to a hospitable and fraternal world, not a self-referential obsession. Under these circumstances, the pursuit for greater longevity acquires true meaning and, above all, a search for satisfactory and dignified ageing—not “successful” which refers to individualism and competitively—in the middle of generous and comforting networks. It is from altruistic LP that other priorities within the field of health care emerge, not driven from life medicalization since they are not effects of propaganda or media persuasion (they do not cope directly with good business) as concerning to the “good death” that, strictly speaking, is an important component of good living.14

Good death for a critic and enlightened consciousness is a good opportunity to continue the struggle for SD in the flesh, allowing or giving priority to everything that respects, preserves, or even better, magnifies it (refusing to what is demeaning, abusive and arbitrary, and assuming important decision making) in an emotional atmosphere which is usually trusted by the assumed LP; from satisfaction for striving for what it is judged as the most valuable human condition; from the well-being with the warm company and reciprocity from our significant others; of peaceful acceptance of what is inevitable and necessary. The good death—imagined in many forms—is certainly almost everybody's aspiration. However, as an individual concern, it usually remains silent and hidden under the implacable censure proffered by monotheistic religions, arguing that all living beings are divine properties.15–17 Despite the obstacles, this unwritten human right, defended by so called “transgressors” of the divine order, progresses in secular worlds by crystallizing rules or behaviors that reclaim the inalienable rights; appearing then concepts and formulas embodied in laws such as the advance directives or living will, the passive euthanasia, the active euthanasia or the assisted suicide. Also, manifestos about the dignified death, painless death or yielding a man the full possession of his destiny arise.18 On the side of health services, there has been rising criticism about the excesses of medical actions in the terminal stage of life or on irremediable circumstances—like therapeutic obstinacy—and promotes its counterparty, quaternary prevention (see part one).

Overall, at the present day, an altruistic LP as a guideline for the LE supposes the unavoidable assumptions about the current historical trance and its generation order (the limitless greed that amplifies inequality, excludes disadvantaged forcing them to live in the dark, transgression or migration, and degrades everything it touches). Its presence makes possible the redesign of the vital priorities inspiring the inescapable responsibility to fight, in any place and in any way, for the human life dignity and other life forms that shape and preserve ecosystems and are the foundations of our viability as species. This leads to the search another leading order of the social, political, and economic movement, which vies real possibilities of a spiritual, intellectual and moral improvement of the communities. In contrast, health care as the center as the priorities of life, compatible with individualism and passivity, is often co-conspirator of the demeaning order. Paradoxically, oneself health care (this applies specificity to health professionals), when takes part of altruistic, trustworthy and consistent LP, obtains its full meaning in the vital context of each person (somatic and psychic support necessary continue in the fight) and often take forms that make it more appropriate to the circumstances, affordable, effective and potentially beneficial.

5Epilogue

Although the good life as a legitimate aspiration to every person is polysemous as a result of the subjectivity characteristics, social status, personal and family history and life expectations, we always tend to think under the lens of individualism and social passivity. Such circumstances, besides media manipulation, have favored the view of health care in the center of citizens concerns in their claim for well living and unusual of the altruistic LP existence.

Induced social passivity has been encouraged and sustained fiercely by the circles of power since the beginning of time, and it has been the foundation of social inequalities throughout the ages. It is the explanation, as a permissive circumstance, for the catastrophic situation we live in, where the hegemonic interests of the financial and speculative capital are imposed without any doubt and damage the vast majority of the population. Hence, this population becomes gradually linked by its misfortunes, organize and assumes increasing levels of participation (overcoming stubborn resistance and enormous obstacles represented by institutions that impose the order that governs the world). These levels of action may mean resistance to abuse and oppression to defend and promote interests that unify the excluded, the homeless, the poor, the dispossessed, the exploited, the idealistic, altruistic or authentic Democrats. By reflecting on the civilizing downfall in which we live, which took place in the presence of the alleged and self-defined mature democracies, it is obvious to infer that it is a farce and a cynical simulation because “the government of the people, by the people and for the people”. Besides, it has never existed as such, it is absent in the politics and the operation of government agencies at a local, regional, national or global level, in any public institution and even more in private ones.

Throughout history, individualism and social passivity have set the fertile ground for the abuse of the powerful elites, which now leads to the global downfall of civilized values. Both approaches result in distrust that questions the beliefs and established truths. They also prevent the awareness of the catastrophic situation that concerns us all, as they anaesthetize the sensitivity towards the suffering and favor the normalization of the limitless degradation as well as conformism and indifference. It is social passivity joined with individualism the dominant characteristics from which we should keep distance if we aspire to a better world.

The current moment accepts no delay: we must be able to envision and move towards a hospitable world, or we will let ourselves to be dragged by self-destruction presented as the only possible world. How we can give up our most primal obligations as inhabitants of one common home, by remaining indifferent to the progressive devastation that happens before our eyes, caused by one system of authoritarian domination, unjust, exclusionary, degrading and unforgiving! It is in this regard that I have argued about the need for LP that transcends individualism and promotes participation, understood as a cognitive adventure that develops a critical attitude towards the established knowledge and a passion for the understanding of oneself and our context; which acquires its true meaning by integrating organized communities, mobilized around values and interests with altruistic nature that claim for SD against degradation. These organizations represent a higher level of participation: by anticipating the undesirable consequences of these looming trends; and building circumstances (counter-trends) that make unviable the unworthy in the future. They would be the hope for a promising world: inclusive, pluralistic, equitable, fair, caring and careful of the ecosystem; which, in subjective terms means spiritual growth, intellectual and moral improvement of the human condition, and in social terms, it means the good life of the majority.

Hence, I believe I have supported the superiority of altruistic and participative LP in the pursuit of the good life through the community (distant from the dominant ideas about it), over health care ideas which favor passivity, individualism and the status quo. The realization of these LP is, in my opinion, the closest path to achieving health. The efforts for the SD as the vital project for criticism of the participants would be somewhat illusory. Without it, we should worry about the care and preservation of the planetary life as a whole: “Mother Earth”19, with its ineffable presence, its poignant majesty and its unfathomable mysteries that, as a creative source of all forms of life that once existed and of current including human, represent the most sublime and venerable, is also a feasible condition for the SD. This struggle for dignity implies infinite possibilities that depend on the priorities according to circumstances; on the urgency of certain actions based on “the current situation”; on the spaces which undertake multiple possibilities; on the instant of the LE of the participants; on the levels of feasibility concerning the chosen strategies; among the multiplicity of facets and levels of expression of the indignity, on the target of the fight. All this aims to demonstrate that the struggle for the SD as a supreme value of human life favors the convergence, affinity and coordination of the various efforts and projects at different stages of development. It is the antidote against meaninglessness, hopelessness, passivity, fragmentation or reductionism which isolates us.20

In conclusion: aware of having dabbled on slippery and controversial land, and by stirring the calm waters of passivity, I aspire that this reading prompts doubts and shakes consciousness which are “sure of their certainties”.

Conflict of interest

The author declares no conflict of interest.

References
[1]
B. Russell.
Bertrand Russell responde.
Granica editor, (1970), pp. 119
[2]
J. Lovelock.
Las edades de Gaia.
Tusquets, (1993),
[3]
J. Lovelock.
La venganza de la tierra.
Planeta, (2007),
[4]
R. Sennett.
El respeto. Sobre la dignidad del hombre en un mundo de desigualdad.
Anagrama, (2003),
[5]
J.A. Marina, M. De la Válgona.
La lucha por la dignidad. Teoría de la felicidad política.
Anagrama, (2000), pp. 98-168
[6]
L. Viniegra-Velázquez.
El sí mismo y el contexto. La educación y la crítica del conocimiento. Una perspectiva transdisciplinaria para entender la subjetividad y sus posibilidades cognitivas.
Invipress, (2015), pp. 149-174
[7]
L. Viniegra-Velázquez.
El progreso y la educación. Educación y crítica. El proceso de elaboración del conocimiento.
Ed. Paidós Mexicana, (2002), pp. 83-103
[8]
L. Viniegra-Velázquez.
La experiencia reflexiva y la educación.
Rev Invest Clin, 60 (2008), pp. 133-156
[9]
L. Viniegra-Velázquez.
La historia cultural de la enfermedad.
Rev Invest Clin, 60 (2008), pp. 527-544
[10]
C. Castilla del Pino.
Función de los Sentimientos III. Teoría de los sentimientos.
Tusquets, (2000), pp. 77-96
[11]
C. Castilla del Pino.
Tipología de los sentimientos. Teoría de los sentimientos.
Tusquets, (2000), pp. 149-170
[12]
L. Viniegra-Velázquez.
La experiencia reflexiva y la educación.
Tusquets, (2000),
[13]
L. Viniegra-Velázquez.
El papel de las ideas en el conocimiento y las ciencias de la vida.
Rev Invest Clin., 66 (2014), pp. 181-193
[14]
L. Viniegra-Velázquez.
Hacia un concepto de salud colectiva.
Salud Pub Mex., 27 (1985), pp. 410-418
[15]
H. Markwell.
End-of-life: a Catholic view.
Lancet., 366 (2005), pp. 1132-1135
[16]
E.N. Dorff.
End-of-life: Jewish perspectives.
Lancet., 366 (2005), pp. 862-865
[17]
A. Sachedina.
End-of-life: the Islamic view.
Lancet., 366 (2005), pp. 774-779
[18]
R. Jaccard, M. Thévoz.
Manifiesto por una muerte digna.
Kairós, (1993),
[19]
J. Lovelock.
La tierra se agota.
Planeta, (2011),
[20]
L. Viniegra-Velázquez.
El reduccionismo científico y el control de las conciencias.
Parte I. Bol Med Hosp Infant Mex., 71 (2014), pp. 252-257

Please cite this article as: Viniegra-Velázquez L. El bien vivir: ¿cuidado de la salud o proyecto vital? Segunda parte. Bol Med Hosp Infant Mex. 2016;73:283–290.

Perhaps the greatest obstacle for a critic conscience is the media manipulation (incorrectly called information or communication), that as consciences control mechanisms, owned by the powers that govern the planet, show a manufactured reality, supposedly objective and inexorable, disseminating or concealing events as suitable, or spreading justificatory versions of the prevailing order or condemnations against the rebel or enemies. The above instils the unarmed minds of the receivers, with overwhelming insistence, the paralyzing fears, the irrational prejudices, unsubstantiated beliefs, the under covered fallacies or the delusions in turn, which are key for the maintenance of the unequal social relations that perpetuate the status quo and encourage individualism.

The term "object", material and symbolic, including the self, close significant others, other intimate living things, different things and situations of great significance; the contingencies of everyday life that break insensible routine or the expected, causing surprise, shock, bewilderment, astonishment or fear.

There is a distinction of the concept "quality of life", developed with quantitative intentions, which refers to the well-being and living conditions of individuals and societies, in addition to health, economic, political, cultural and ecological aspects. It has also been defined as the degree to which a person enjoys the important aspects or possibilities of life. In this concept, individualism is an unquestioned assumption, and the struggle for human dignity is unthinkable.

Copyright © 2016. Hospital Infantil de México Federico Gómez
Article options
Tools
es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.