What is the relation of health with ethics and aesthetics?

Recent times have witnessed the great divide between science and art. Medicine kept itself aloof from the question of aesthetics apart from a few poems in journals. The complexity of life today however has brought these issues back to the forefront. Questions arise. Would the withdrawing of life support from a comatose patient affect the physician himself? Especially when he has been brought up in a culture where administering water to the dying is a time honoured custom. Is it essential to play soothing music in the operation theatre? Medical professionals have already started thinking about ethics. The ethics of euthanasia, ethics of medical research, ethics of medical practice, ethics of organ transplant, ethics of abortion, ethics of invasive investigations etc. But aesthetics is hardly explored. Can an absence of beauty affect health? It seems that the conflicts between ‘aesthetics’ and ‘ethics’ have a direct bearing on personality development and mental health. This is seen clearly in hospice situations where the doctor may feel that a prolongation of life would mean increasing the suffering but is morally obliged to prescribe drugs. The sensitive, aesthetic part conflicts with the moral ethical part. How to resolve this? What happens to medical personnel caught in this conflict?

As beauty and pleasure go together, the aesthetic man is essentially hedonistic. There are however grades of hedonism. While there is a hedonistic side of morals expressed through gentleness, love and amenity, there is also a hedonistic side of the vital consciousness expressed through the seeking of pleasure by whatever means one has at one’s disposal. This is manifest in the search for substances that help to avoid pain. As a result, we are left with an over-medicated society where chemical agents are used to cope with a growing number of personal and social problems. The abuse of narcotics and psychotropic drugs is also, in a way, one of the end results of a culture leaning too much to the aesthetic side.

On the other hand, the exclusively ethical man appears to be dry and dogmatic. A purely ethical set of rules would be impractical at the individual level, a forceful suppression of an external law like prohibition of alcohol may lead to an increase in illicit liquor trafficking. An overemphasis on ethics leads to ‘guilt’ as an important symptom of depression and obsessive compulsive neurosis. Ethics alone has no solution for man. In India, the spiritual culture points towards a supra-ethical dimension that surpasses the notion of guilt. While the West stresses the ‘sin-righteousness’ dimension, Indian spirituality stresses the ‘knowledge-ignorance’ dimension where ‘ignorance’ is a type of lower knowledge which is unaware of the unity that pervades all creation. In this paradigm the solution is progressive growth, through many lives.

The progress of a culture necessitates an upward movement. The cruder elements of life have to be refined, shaped, sublimated, reconciled and transformed so that we can lay claim on an accomplished humanity. But what happens if civilisation refuses to progress?

We are already witnessing the rudimentary beginnings of such a phase of devaluation manifested in alienation, boredom, meaninglessness in life, unexplained teenage murders and suicides, pact suicides by multiple partners, killing binges, shifting patterns of drug abuse, rising fanaticism, terrorism and suicide squads and the shameless exploitation of ecosystems.

A balance between ethics and aesthetics is thus needed for a sense of fulfillment in life also. This sense of fulfillment is essential for a stability in health.

The balance however is very precarious and has resulted in great historical upheavals and changes in value-systems. This is best exemplified in the history of ancient Athens which exhausted its creative vitality within one century because it could not balance its aesthetic sense by discipline of character. Likewise, Rome and Sparta suffered from stagnation when their predominantly ethical culture overshadowed aesthetic values.

Our inability to harmonise ethics and aesthetics has its repercussions in the contemporary culture also. Thus, on one hand, a hedonistic culture, shedding all its inhibitions, has fostered new types of diseases like AIDS, drug abuse etc., — the end-result of a culture whose repertoire of desires is satiated but never satisfied. On the other hand, an unduly dogmatic ethical overture (like enforcement of prohibition or imposition of Talibanisation) has become a mockery of the very symbols it wants to project.

The synthesis of ethics and aesthetics can begin in every physician’s chamber. We have to create a healing space where a balance between ethical and aesthetic values manifest in a harmony. What happens if a healing space is aesthetically designed? What happens if aesthetics is left out from an otherwise ethical design?

This issue of NAMAH carries an account of a detoxification centre for pedlar-criminals who were also consuming heroin. With such clientele neither ethics nor aesthetics counted. The failure of ethics was evident when a critically dominant father-position taken by the counsellor (in Transactional Analysis terms) failed to establish any rapport with the clients. The counsellors could not think of any aesthetic values to be imparted to this criminal patient population because their socio-educational level never imparted any sense of beauty to them. In the absence of ethics and aesthetics, the innovative program for pedlar-addicts could not be sustained with the inspiration and spontaneity with which it was initiated.

This issue also carries an article by a psychotherapist who brings in his artistic creations full of symbolisms to enrich his therapeutic space. This is also an interesting area for study: to see how aesthetics influences the therapist-patient interaction.

Healing is a complex process. We may not always be aware of the various factors which operate to disturb the balance of health. In fact, many times, it is only an appearance of health that a person gives. Only when the disequilibrium becomes apparent physically is it classified as a disease. The various therapeutic methods in their own ways try to re-establish a harmony which might not go back to the original state. A perfect harmony can be established when the entire being is integrated around its central truth. A synthesis of ethical and aesthetic values can result from this harmony.

“Neither the ethical being nor the aesthetic being is the whole man, nor can either be his sovereign principle; they are merely two powerful elements. Ethical conduct is not the whole of life; even to say that it is three-fourths of life is to indulge in a very doubtful mathematics. We cannot assign to it its position in any such definite language, but can at best say that its kernel of will, character and self-discipline are almost the first condition for human self-perfection. The aesthetic sense is equally indispensable, for without that the self-perfection of the mental being cannot arrive at its object, which is on the mental plane the right and harmonious possession and enjoyment of the truth, power, beauty and delight of human existence. But neither can be the highest principle of the human order. We can combine them; we can enlarge the sense of ethics by the sense of beauty and delight and introduce into it to correct its tendency of hardness and austerity the element of gentleness, love, amenity, the hedonistic side of morals; we can steady, guide and strengthen the delight of life by the introduction of the necessary will and austerity and self-discipline which will give it endurance and purity. These two powers of our psychological being, which represent in us the essential principle of energy and the essential principle of delight, — the Indian terms are more profound and expressive, Tapas and Ananda, — can be thus helped by each other, the one to a richer, the other to a greater self-expression” (1).

This will also rejuvenate the natural healing energies of the bodily system, and will make one accessible to the universal energy-movements in nature.

Ethics and aesthetics