I have a dream...that the phrase "quality of life" will be forever banned from our language. These words, which I encounter on a daily basis, provide no meaning, no clarity, no objectivity and do confuse to no end. These words contribute to a judgmentalism which often results in a rejection of life, of living and an understanding of suffering.
Is "quality of life" a criteria by which we justify the movement in some areas of our country toward "assisted suicide?" Is "quality of life" the criteria which we assume to be a basis for accepting a variety of eugenic beliefs? Is "quality of life" the criteria which we use to place Do Not Resuscitate Orders on the infirm and the disabled? Is our definition of "quality of life" the reason that the infirm and the disabled are institutionalized and removed from their only safe haven...family and loved ones. Is "quality of life" a reason that we fail to take extraordinary measures to preserve life? Is "quality of life" a reason used to justify growth attenuation and whose quality of life are we referring to? The child's or the adult's? At which point is intractable suffering sufficient to justify termination of living? And, at which point is "quality of life" a merely subjective phrase to justify unjustifiable actions?
Of course, health providers have attempted to quantify "quality of life"? Economists, sociologists, medical groups, psychologists have all attempted to quantify and objectify "quality of life" indicators. Are the variables money, friends, spouses, location, the environment, sufficient health? Are the contra-indicating variables pain, persistent vegetative states, immobility, lack of communication abilities, coma? What about the simplistic definitions emanating from the "quality of life project?"
I believe that we often attempt to define quality of life in order to establish a criteria to end life. Assisted suicide initiatives, legal only in Oregon, Washington and Montana and much to my great dismay on the ballot in my Massachusetts in 2012 (the U.S.), rely on self-definitions and self-perceptions of quality of life and a determination whether life is worth living. Extensive studies in Oregon which concerned assisted suicide indicate that motivations and people's reasoning is quite clear. The main reason for choosing to die was the "loss of autonomy", followed by "loss of dignity" and followed by "loss of bodily function." Should we be honest and say that all three relate to incontinence and have little to do with intractable pain. The latter was far down the list. Is this perceived indignity a criteria for "quality of life?"