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Architecture, Human Flourishing, and Health Care
Architecture, Human Flourishing, and Health Care
Jul 13, 2025 5:20 AM

In a recent issue of Metropolis Magazine, Thomas de Monchaux tells the story of an amazing lesson about innovation that Americans can learn from Rwandans. This is no surprise, but readers will learn that burdensome government regulations stifle innovation and undermine human flourishing.

De Monchaux recounts the story of Michael Murphy, executive director and co-founder of the Boston-based MASS Design Group, and Alan Ricks, MASS cofounder and COO, attempting to take what they learned from building health care facilitates and hospitals in Rwanda, with minimal building code regulations, and bringing that knowledge to building in the United States. He describes the project in Butaro, Rwanda this way:

The guiding principles of the Butaro project included what Ricks described as, “not designing a perfect building, but a building that is capable of failing safely, with passive systems always supplementing mechanical systems, ing back to an idea of resilience—which of course is the hot topic right now,” in our era of economic scarcity and increasingly extreme weather.

Murphy and Ricks wanted to build medical buildings that served the needs of munities and they were free to do so because the Rwandan government got out of the regulatory way. They did not need a perfect building but one that met actual and immediate needs for those in that munity. These architects were given freedom to solve local problems and meet local needs rather than succumb to the pressure to design buildings to meet expectations and regulations of government officials who require guidelines for those who might enter the building. In the United States, local architects don’t have as much freedom to solve local problems in local ways that contribute to human flourishing than they do in the developing world. De Monchaux continues,

In the U.S., Murphy observes, hospitals are subject to “incrementally implemented and overlapping zoning codes, which can make it difficult in some cases to innovate. And many existing buildings suffer from the same kind of implementation problem, in which buildings are aggregated over time. Most hospital buildings were intended to grow and modate change in a systematic way, but they get stuck, fixed in time, or sprawl horizontally. . . . Rwanda, Murphy notes, faces severe limitations in its health care infrastructure, but neither is it “burdened by a stifling system of codes and regulations,” which, however necessary and well-intentioned, can strangle creativity.

Being burdened by the ever-increasing bureaucratic machine in the U.S. is undermining the type of creativity needed to solve more and more of our problems in architecture and many other sectors of society. What could be better than more efficient and healthier medical facilities? Why kill this with needless regulations? Sustainable human flourishing depends on men and women being free to use their entrepreneurial creativity for mon good. There is nothing more tragic in the United States than to witness the unintended consequences of incremental and overlapping federal, state, and local regulations that kill innovation. It’s a three ring circus. These regulations are pitched as a means of protecting the public interest but the only thing they are “protecting” us from, many would argue, is progress.

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