Academic journal article International Public Health Journal

Quality of Life: Four Under-Considered Intersections

Academic journal article International Public Health Journal

Quality of Life: Four Under-Considered Intersections

Article excerpt

Introduction

In this paper, I make a modest proposal. It is that those of us involved in the science of quality of life should intersect the science with four under-considered constructs. These are (a) personhood and the social construction of disability; (b) the implications of social constructions for communities and their laws; (c) the consequences of questions that are both self-referential and other-regarding; and (d) compassion, trust, and dignity. As I address each of these, I call attention to some of their policy and legal implications.

I do not intend to describe fully each intersection. Readers presumably already understand the underlying constructs related to quality of life, personhood and social construction of disability, issues of regarded-ness, and compassion, trust, and dignity. Instead, I intend to stimulate a discourse around the proposition that quality of life consists of more than the measurable domains that scientists have identified to date. In this respect, I seek to enlarge our understandings about quality of life and to challenge the scientific community to concern itself with some of the law and policy implications of their invaluable science.

I also seek to show that an enlarged understanding about quality of life is entirely consistent. Brown and Faragher (1) invites us to consider how and why many others generalize from the field of intellectual and developmental disabilities. That kind of generalization is explicit in papers Faragher, Broadbent, Brown, and Burgess (2) about education; Wilson (3) about mathematics; McArthur and Faragher (4) about children with disabilities and other challenging circumstances; and Ajuwon and Bieber (5) about blindness.

Ajuwon and Bieber's paper (5) makes the important point that the power of imagination and creativity are elements of quality of life that have yet to be factored into the science of quality of life. Indeed, if I were to rewrite my paper, I most certainly would have included imagination and creativity as domains of quality of life.

Still by way of introduction, one more point is worth making. It is that, indisputably, quality of life science concerns itself with well-being and basic needs and thus with the means for attaining them through policy and practice (6).

Scientists have determined the dimensions of quality of life, as various chapters in this book indicate. And, legal analysts have identified the core concepts of policy - those legal precepts without which policy will not readily advance quality of life. Fortuitously, the combination of quality of life science and policy analysis can provide an evidence-based foundation for still further quality of life research and advancements in policy and practice (7). It is that "next step" with which I am especially concerned here.

To begin the "next step," I propose that four matters deserve our consideration. To put them into a loosely logical order, I begin with the construct called personhood.

The first intersection: Personhood and social construction

The term personhood refers to the how, under national or local norms and law, a person is represented and responded to by others (8,9). It is a bestowed status; it arises in the context of relationships (10); it reflects the degree to which a person has social value (1l); and it changes over time (12).

Congruent with these understandings about personhood, the social construction theory holds that disability is, in large if not entire part, a consequence of how norms, mores, policies, and built environments "cause" an impairment to become a disability (13). Social construction theory is at the root of QOL science. The very life of the person with an impairment is converted to a "disabled" status by how the person is regarded by others. One consequence of this transformation is that the quality of life of a person with a disability is regarded in relationship to the quality of life of those without disabilities and others with disabilities. …

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