Eudynamic bioethics.
Luis De Miranda
Medicine, Health Care, and Philosophy September 27, 2026 DOI: 10.1007/s11019-026-10404-9 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Keywords | 4e cognition Bioethics Compossibility Dysdynamia Eudynamia Philosophical health |
| Key points | Argues that bioethics needs the concept of "eudynamia"—the distributed activity of composing possibilities across a life so that securing one does not foreclose others—because defensible individual clinical decisions can still fail the existential composition around them. Proposes "dysdynamia" for configurations in which local effectivity forecloses the wider life, and contends that bioethics must ask not only whether each decision is right but what forms of life its right decisions, taken together, make possible. |
Abstract
A woman's chronic pain is controlled to a stable score, yet her sleep, her work, her singing, and her partnership have narrowed around her condition. Each clinical decision was defensible; what failed is the existential composition around them. This article proposes eudynamia as the concept bioethics lacks: the distributed activity through which possibilities are composed across the conditions of a life so that securing one does not foreclose the others. Ernst Daniel August Bartels coined Eudynamie in § 55 of his Lehrbuch der allgemeinen Pathologie (1819) for a physiological capacity working as it should, then observed that its value changes with the capacities beside it. His relational biology identified the configurational problem but lacked an account of what a life-capacity is a capacity for. Phenomenology and 4E cognition supply the missing content, understanding life and cognition as distributed: embodied, extended, enactive, and embedded. Eudynamia is accordingly reconstructed as the work of keeping possibilities compossible across Person, Earth, Work, and Society, while dysdynamia names configurations in which local effectivity forecloses the wider life. Canguilhem's biological normativity then distinguishes compossibility from coercive coherence, since eudynamic integration preserves the creative capacity to institute new norms. The framework is illustrated in integrative care, antimicrobial stewardship, and artificial intelligence. Bioethics has learned to ask whether each decision is right. It must also learn to ask what forms of life its right decisions, taken together, are making possible.