Number of Citations: 0

Submitted: 6 February 2025
Accepted: 14 May 2025
Published online: 7 October, TAPS 2025, 10(4), 94-96
https://doi.org/10.29060/TAPS.2025-10-4/II3664

Charlene Tan¹ & Ruth Neo²

¹College of Arts, Humanities and Languages, Life University, Cambodia; ²UNSW Medicine & Health, University of New South Wales, Australia

I. INTRODUCTION

This article proposes a Chinese philosophical approach to well-being for medical education by drawing on the thought of Mencius (372-289 B.C.E.). As it is not possible to cover all areas of Mencius’ philosophy within this short essay, our focus is on Mencius’ idea of interpersonal joy, as recorded in the classic Mengzi. This paper shall explain how interpersonal joy, from a Mencian perspective, centres on the shared delight from benefiting others while cultivating personal virtue.

II. MENCIUS ON WELL-BEING AND INTERPERSONAL JOY

Well-being is used synonymously or in conjunction with related terms such as welfare, happiness, prudential value, the good life, prudential good life, quality of life, flourishing, self-interest, fulfilment, utility and pastoral care (Fletcher, 2016). Mencius’ approach to well-being is encapsulated in his idea of interpersonal joy, which harmonises personal and communal delight. A representative passage is 7A20.1 in the Mengzi:

Mengzi said, “An exemplary person [Junzi] takes joy in three things, and being King of the world is not one of them. The person’s first joy is that one’s parents are both alive and one’s siblings have no difficulties. The second joy is that looking up one is not disgraced before Heaven, and looking down on one is not ashamed before humans. The third joy is getting assistance and cultivating the brave and talented people of the world. An exemplary person takes joy in three things, and being King of the world is not one of them (Van Norden, 2008, p. 176).

This passage is about a Junzi which literally means ‘son of a noble’. Confucius appropriated this historical term and infused it with moral import, thereby changing its meaning to denote an exemplary person. That the exemplary person embodies Confucian well-being is evidenced by passages in the Mengzi that describe such a person as having “no anxieties” (4B28.7) and experiencing “joy” (7A20.1, 7A21.2).

With respect to 7A20.1, the passage begins by stating that an exemplary person does not derive joy from being King of the world. Mencius is not asserting that holding political power is wrong or detrimental to one’s well-being. On the contrary, he acknowledges in the next passage that an exemplary person, like all rulers, “desires a large territory and numerous people” (7A21.1). Mencius’ point is that Kingship, in itself, does not give satisfaction to an exemplary person; instead, such a person “takes joy in taking one’s place in the middle of the world and making all the people within the Four Seas settled” (7A21.1) (Van Norden, 2008, p. 176). We see here how an exemplary person obtains personal joy by bringing joy to others (“making all the people within the Four Seas settled”).

All people can become exemplary people by developing the four sprouts within them, namely the mind-and-heart of compassion, the shame of evil in oneself and hatred of evil in others, humility and deference, and right and wrong (2A.6). These four sprouts, when consistently cultivated, will grow into the virtues of benevolence, propriety, righteousness and wisdom, all of which contribute to interpersonal joy.  Retuning to 7A20.1, Mencius’ message is that an exemplary person does not obtain pleasures and life satisfaction from prudential desires, which are manifested in egoistic ambitions with little regard for others. Instead, joy is felt when a person immerses oneself in social interactions and builds strong connections with others. An exemplary person also derives delight by treating others well and developing their potential for the common good. The end result is “making all the people within the Four Seas settled” (7A21.1) (Van Norden, 2008, p. 176).

To sum up, Mencian well-being is indicated by interpersonal joy which integrates individual and collective happiness, as demonstrated by the exemplary person. Communal joy engenders collective well-being, illustrated by the King “sharing the same delight as the people” (1B1.4) (Van Norden, 2008, p. 16).

III. RECOMMENDATIONS FOR MEDICAL EDUCATION

A major implication of Mencian well-being is for medical schools to promote interpersonal joy in the curriculum and assessment. Two suggestions are elaborated in this section: a shift from summative assessment and competition to formative assessment and collaboration; and the introduction of a wellness curriculum that pivots on interpersonal joy.

First, medical schools need to review their curriculum and assessment so as to remove any hindrances to the realisation of interpersonal joy in their students. A specific recommendation is to replace summative assessment and competition with formative assessment and collaboration. Mencius’ call for collective well-being is difficult to achieve if students are fixated with outperforming one another due to the pressures of high-stakes exams. Kachel et al. (2020) report that “during medical school interpersonal skills linked to being an active member of an institution are underrepresented in curricula” (p. 11). It is a challenge for medical students to care for the well-being of others and be open about their mental health needs if they are circumscribed by a culture of competition, distrust and judgement (Canadian Federation of Medical Students, 2021). Cooperation and interdependence can be enhanced by reducing or removing pen-and-paper examination and norm-referenced assessments, and introducing (more) collaborative projects and criterion-referenced assessments. The assessment mode for the cultivation of interpersonal joy should be formative, where students are given continuous feedback and find enjoyment in learning and sharing.

A pedagogical approach to foster interpersonal joy is group projects, where students collaborate for shared success. Anchored upon the principles of cooperation and harmony, group projects foreground interpersonal joy and competencies that are underrepresented in the curricula (Kachel et al., 2020). Termly group projects nurture communication and teamwork skills, spanning a wide range of topics from the basic clinical sciences to medical ethics and public health. The group projects can be evaluated via negotiated assignment, where students develop their own research questions and set their own assessment criteria that are aligned with the course themes. The goal is to foster student-driven learning that gives students the opportunity to explore common topics of interest beyond the confines of standard, end-of-course examinations. A related pedagogical approach is encouraging students to participate in service learning, community involvement as well as local and overseas volunteer projects, so as to generate communal interactions and bonding. By serving others, the students’ sprout of compassion is cultivated and manifested through empathy, beneficence and concern for others (Van Norden, 2008).

The second recommendation is for medical schools to enact a wellness curriculum that pivots on interpersonal joy. Medical schools could adapt the wellness curriculum for medical students in a Canadian university; students there were asked to “define their core values and beliefs while respecting those of others, and apply them in the context of their developing physician identity and that of the medical profession” (Canadian Federation of Medical Students, 2021, p. 22). Mencian ideas can be integrated into the before-mentioned wellness curriculum through reflective questions such as: What does an exemplary person (junzi) mean to me? How can Mencian interpersonal joy be part of my core values as a medical professional? How can I obtain interpersonal joy through interacting with and serving others? The self-reflection activity can be undertaken in various formats such as group discussions, journalling and multi-media presentations.

Mencian ideas of well-being and related suggestions may face challenges in medical schools where individualism and competition are often culturally entrenched. In this regard, Mencian well-being may be more appropriate for medical education in Confucian heritage cultures. Significantly, studies have shown that Asian adolescents experience a strong sense of well-being when they partake in collective activities; in contrast, adolescents in Anglo-American societies typically enjoy higher well-being when they engage in more individualistic activities (Chue, 2023). Relatedly, Mencian well-being’s focus on moral cultivation sets it apart from two dominant models in Anglophone societies, namely Seligman’s PERMA (Positive emotions, Engagement, Relationships, Meaning & Accomplishment) and Ryff’s six aspects of psychological well-being, which are autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. As noted earlier, Mencius advocates for the development of our innate goodness in the form of the four sprouts, which in turn contributes to interpersonal joy. In contrast, the theories of Seligman and Ryff generally de-emphasise moral education.

In individualistic societies, interpersonal joy can complement the existing wellness frameworks by underscoring collaborative learning, such as group projects and service learning (Bourcier et al., 2021). Staff development is also critical, where faculty members are introduced to Mencian principles and practical ways to promote them, such as organising service learning and designing wellness curricula. Ultimately, the successful implementation of interpersonal joy necessitates faculty development, which should be strategically incorporated into the staff training programmes (Canadian Federation of Medical Students, 2021).

IV. CONCLUSION

Mencius’ approach to well-being is encapsulated in his idea of interpersonal joy, which harmonises personal and communal delight. Mencian well-being supports collective well-being by twinning self-interests and other interests. This paper has also suggested that medical schools revamp the curriculum and assessment modes to shift from summative assessment and competition to formative assessment and collaboration. Medical schools should also explore pedagogical methods that incorporate Mencian idea of interpersonal joy into the curriculum.

Notes on Contributors

Charlene Tan conceptualised the topic, provided philosophical ideas and drafted the manuscript. Ruth Neo gave inputs that pertained to medical student well-being and co-drafted the manuscript.

Ethical Approval

Ethical approval is not relevant as this is a conceptual paper that does not involve human participants and/or animals.

Acknowledgement

The authors thank the anonymous reviewers for valuable suggestions to earlier drafts.

Funding

The authors did not receive support from any organisation for the submitted work.

Declaration of Interest

No potential competing interest was reported by the authors. The authors have no relevant financial or non-financial interests to disclose.

References

Canadian Federation of Medical Students. (2021). Canadian federation of medical students wellness curriculum framework. https://www.cfms.org/files/wellness-resources/CFMS-Wellness-Curriculum-Framework_FINAL.pdf

Chue, K. L. (2023). Cultural issues in measuring flourishing of adolescents. In R. B. King, I. S. Caleon, & A. B. I. Bernardo (Eds.), Positive psychology and positive education in Asia: Understanding and fostering well-being in schools (pp. 329-342). Springer.

Fletcher, G. (Ed.). (2016). The Routledge handbook of philosophy of well-being. Routledge.

Kachel, T., Huber, A., Strecker, C., Höge, T., & Höfer, S. (2020). Development of cynicism in medical students: Exploring the role of signature character strengths and well-being. Frontiers in Psychology, 11(328), 1-16. https://doi.org/10.3389/fpsyg.2020.00328

Van Norden, B. W. (2008). Mengzi. With selections from traditional commentaries. Hackett Publishing Company, Inc.

*Charlene Tan
Life University, Phreah Sihanouk,
Sihanoukville, Cambodia
Email: chptan@u.nus.edu