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Philosophical Quality of Life and Ethical Dimensions - Future Work On Quality Of Life

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Reviewing each of these three philosophical approaches to quality of life, one can argue that the concept of quality of life should not be construed as a floor below which no significant societal expenditure of resources is required, and below which personal caregiving efforts may be reduced to the decent minimum. A much better way to think about quality of life is to see it as a ceiling, a potential level of functional capacity and capacity for relationship, toward which caregiving efforts should be designed to strive. The height of this ceiling will not be the same for everyone, and quality of life is not a test that you fail if you do not reach a certain height. But the important point is that quality of life should be used as a teleological concept—setting a goal to reach and a process to reach it, rather than as a prioritizing concept—setting a rank ordering for the allocation of scarce resources.

In conclusion, it is important to note that no one of these philosophical theories has completely carried the day among philosophers, and each of the three is still under development in the philosophical literature on quality of life. None of them offers a complete account; elements of all three are essential to cover the broad range of circumstances and individual needs pertinent to the issue of quality of life in an aging society.

BRUCE JENNINGS

BIBLIOGRAPHY

ALBERT, S. M., and LOGSDON, R. G., eds. Assessing Quality of Life in Alzheimer’s Disease. New York: Springer, 2000.

BROCK, D. ‘‘Quality of Life Measures in Health Care and Medical Ethics.’’ In The Quality of Life. Edited by M. C. Nussbaum and A. Sen. New York: Cambridge University Press, 1993. Pages 95–139.

COHEN, C. ‘‘‘Quality of Life’ and the Analogy with the Nazis.’’ Journal of Medicine and Philosophy 8 (1983): 113–135.

DRESSER, R. S. ‘‘Life, Death and Incompetent Patients: Conceptual Infirmities and Hidden Values in the Law.’’ Arizona Law Review 28 (1986): 373–405.

DRESSER, R. S., and ROBERTSON, J. A. ‘‘Quality of Life and Non-Treatment Decisions for Incompetent Patients: A Critique of the Orthodox Approach.’’ Law, Medicine, and Health Care 17 (1989): 234–244.

DWORKIN, R. Life’s Dominion. New York: Knopf, 1993.

GOODE, D., ed. Quality of Life for Persons with Disabilities: International Perspectives and Issues. Cambridge, Mass.: Brookline Books, 1994.

Hastings Center. Guidelines on the Termination of Life-sustaining Treatment and the Care of the Dying. Bloomington: Indiana University Press, 1987.

JENNINGS, B. ‘‘A Life Greater than the Sum of Its Sensations: Ethics, Dementia, and the Quality of Life,’’ In Assessing Quality of Life in Alzheimer’s Disease. Edited by S. M. Albert and R. G. Logsdon. New York: Springer, 2000. Pages 165–178.

LAWTON, M. P. ‘‘A Multidimensional View of Quality of Life in Frail Elders.’’ In The Concept and Measurement of Quality of Life in the Frail Elderly. Edited by J. E. Birren, et al. New York: Academic Press, 1991. Pages 3–27.

LIFTON, R.J. Nazi Doctors. New York: Basic Books, 1986.

MCCORMICK, R. ‘‘The Quality of Life, the Sanctity of Life.’’ Hastings Center Report (February 1978): 30–36.

MOSS, S. ‘‘Quality of Life and Aging.’’ In Quality of Life for Persons with Disabilities: International Perspectives and Issues. Edited by D. Goode. Cambridge, Mass.: Brookline Books, 1994. Pages 218–234.

NUSSBAUM, M. C., and SEN, AMARTYA, eds. The Quality of Life. New York: Cambridge University Press, 1993.

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SCANLON, T. ‘‘Value, Desire, and Quality of Life.’’ In The Quality of Life. Edited by M. C. Nussbaum and A. Sen. New York: Cambridge University Press, 1993. Pages 185–200.

SOLOMON, M. Z., and JENNINGS, B. ‘‘Palliative Care for Alzheimer Patients: Implications for Institutions, Caregivers, and Families.’’ In Hospice Care for Patients with Advanced Progressive Dementia. Edited by L. Volicer and A. Hurley. New York: Springer, 1998. Pages 132–154.

TAYLOR, S. J. ‘‘In Support of Research on Quality of Life, but Against QOL.’’ In Quality of Life for Persons with Disabilities: International Perspectives and Issues. Edited by D. Goode. Cambridge, Mass.: Brookline Books, 1994. Pages 260–265.

WOLFENSBERGER, W. ‘‘Let’s Hang Up ‘Quality of Life’ as a Hopeless Term.’’ In Quality of Life for Persons with Disabilities: International Perspectives and Issues. Edited by D. Goode. Cambridge, Mass.: Brookline Books, 1994. Pages 285–321.

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