Towards self-determination in quality of life research: a dialogic approach.
Health-related quality of life measures aim to assess patients' subjective experience in order to gauge an increasingly wide variety of health care issues such as patient needs; satisfaction; side effects; quality of care; disease progression and cost effectiveness. Their popularity is undoubtedly due to a larger initiative to provide patient-centered care. The use of patient perspectives to guide health care improvements and spending is rooted in the idea that we must respect patients as self-determining agents. In this paper I look at the two main orientations to quality of life measurement: standardized and individualized measures. I argue that while these measures are attempts to provide for patient self-determination, they both fail to do so. In their place I suggest a new approach which overcomes their respective difficulties: a dialogic approach.
McClimans
Leah
L
Department of Philosophy, University of South Carolina, Columbia, SC 29208, USA. mccliman@mailbox.sc.edu
D006801:Humans; D010358:Patient Participation; D026684:Personal Autonomy; D010686:Philosophy, Medical; D011788:Quality of Life; D012107:Research Design