Quality of Life: The Contested Rhetoric of Resource Allocation and End-of-Life Decision Making

Abstract

The term “quality of life” has a long history in the bioethics literature. It is usually used in one of two contexts: in resource allocation discussions in the hope of arriving at an objective measure of the worth of an intervention; and in end-of-life discussions as a concept that can justify the forgoing of life-sustaining treatment. In both contexts, the term has valid uses as it is meant to measure the efficacy of a treatment. However, the term has the unfortunate rhetorical problem that it often seems to be a judgment on the life of a human being. As such, it is highly inflammatory. We suggest that a return to a rhetoric that suggests a judgment on the treatment rather than the person is needed.

Keywords:

• bioethics
• disability
• quality of life
• resource allocation
• rhetoric
• substituted judgment