As medicine strives to provide person-centered care, it is essential that clinicians support the subjective well-being of people living with serious illness. Toward this end, addressing the subjective suffering of an individual is now recognized as complementary to medicine’s goals of treating disease. Joy, on the other hand, has generally fallen outside the purview of medicine, despite its central role in subjective well-being.
Although improving quality of life may appear synonymous with relieving suffering, these goals are conceptually and practically distinct. Quality of life includes both positive and negative dimensions that do not have a simple dependent association or lie along a single continuum.1 This means that reducing an aspect of negative experience (eg, pain) will not necessarily increase positive experience (eg, pleasure). Any therapeutic framework solely focused on reducing suffering misses opportunities to directly promote these positive dimensions of quality of life. Moreover, such frameworks present a limited picture of personhood that underemphasizes the aspects of life underlying people’s fondest memories and dreams.