Assessing quality of life. Moral implications for clinical practice

The purpose of this paper is to examine some of the moral implications for clinical practice of the move toward measuring or assessing quality of life. For purposes of this presentation, discussions of the good life or quality of life have at least two "conceptual" preconditions. First is biologic life; second is a minimum cognitive apparatus to attach meaning to life (or a capacity for self-awareness). Quality of life measurement in clinical care has three principal uses: screening, monitoring, and decisionmaking. The paper discusses how increasing reliance on quality of life measures is potentially morally appealing in all these cases, but also how moral "downsides" may be created that should be recognized and confronted with appropriate moral constraints.