Some Moral and Political Pitfalls in Measuring Quality of Life
John D. Lantos
The University of Chicago
This book focuses, to a large extent, on methods for measuring quality of life (QOL) in children and their applications for children with a range of clinical problems. The book includes discussion of different approaches for assessing QOL, ranging from the most methodologically complex survey instruments to the simple technique of asking a child, "How are you?"
Such a volume is crucial at this juncture. It should stimulate and advance a field that offers real promise of reorienting pediatric care. The need for such a volume suggests that we need reorienting. For the types of questions we face today and will face more frequently in the future, we seem to be wandering around without a compass. In some areas of the field, we are not sure what exactly is or is not a disease, what ought or ought not to be properly considered a therapy, what the goals of pediatrics are or ought to be, and what sorts of measurements of outcomes might best help us answer these fundamental questions. Although the book necessarily focuses on smaller methodologic questions, it is important for readers also to keep a critical eye on these larger issues.
I am less concerned about the particulars of QOL assessment than I am about a more general question: What do we mean by "quality"? A subsidiary question asks what we are doing when we try to quantify an