Moral Imagination in Medicine | Lydia Dugdale, MD

The Doctor's Art

Moral imagination is the ability to transcend one's own immediate context and experiences to explore diverse moral perspectives and ethical scenarios. In medicine, where decisions can reverberate profoundly through a patient’s life, moral imagination allows us to navigate the ethical complexities of particular situations while honoring the dignity of others. But how can this capacity be developed? Can we actually teach moral imagination to clinicians? In this episode, we are joined by Lydia Dugdale, MD, director of the Center for Clinical Medical Ethics at Columbia University, who has deeply explored these issues through her writings and research. She is the author of multiple books, most recently The Lost Art of Dying: Reviving Forgotten Wisdom, (2020). Over the course of our conversation, Dr. Dugdale shares her efforts to nurture moral imagination in her students, the importance of acknowledging suffering not just between clinicians and patients, but also among clinicians themselves, what sustains her through the most challenging or mundane moments in medicine, and more.

In this episode, we discuss:

2:31 - Dr. Dugdale’s calling to medicine

5:06 - How Dr. Dugdale became interested in clinical ethics

8:49 - Why it’s difficult to engage the spiritual side of medicine

16:18 - The importance of cultivating imagination, especially for physicians

21:44 - The place that higher education has (or doesn’t have) in shaping the “souls” of students

27:25 - The importance of creating space to reflect on the patient connection

36:14 - Dr. Dugdale’s advice for trainees and clinician on how they can better approach addressing suffering with patients

In this episode, we discussed Alan Deresiewicz book “Excellent Sheep: The Miseducation of the American Elite and the Way to a Meaningful Life” (excerpt from which is published in The New Republic) as well as Steven Pinker’s response essay The Trouble with Harvard.

Dr. Dugdale is the author of The Lost Art of Dying: Reviving Forgotten Wisdom.

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