Lewenskwaliteit in biomediese konteks : filosofies-etiese ondersoek

[摘要] ENGLISH ABSTRACT: Every individual has a mental image of what a 'good' life entails. Whether thisidea of a good life is based on hedonist, preference satisfaction or idealtheories, or a combination of these theories, it forms the underlying frameworkthat indicates and measures how well or how poorly we are doing. The smallerthe discrepancy between these suppositions we nurture and our realcircumstances, the greater the degree of wellbeing and satisfaction weexperience. This satisfaction with our lives can be indicated on objective andsubjective scales, and these serve as a direct reflection of our quality of life.In addition to self experienced quality of life, quality of life is also seen as the aimof health care. However, as the World Health Organization (WHO) sketches analmost utopian view of health, the field is deemed to be so wide that it includesman in his totality. This state of total psychological, physical and social welfare isfurther seen as a primary or basic necessity to which everyone is entitled. Humanwelfare, or quality of life, viewed from a healthcare perspective, serves as thecriterion for substantiating, informing and guiding health care. Not only arechoices regarding the type and degree of intervention in the therapeutic situationguided by this, but quality of life is also regarded as the single cut-off point fordetermining whether continued existence would be better or worse than notexisting at all.A further outcome of quality of life is the use of QALYs (quality-adjusted lifeyears) and TTO (Time trade-off). These instruments are designed to determinethe net efficiency of therapeutic intervention by combining two dimensions,namely quality and quantity of life. Quality of life and [healthy] lifespan aretherefore combined in a single framework of value assessment, and thisframework is applied as the main criterion for allocating limited resources. Thisapplication of quality of life has been adjusted to serve as the main measure fordetermining the value of a life.In this study quality of life will critically be investigated with the focus on selfexperienced quality of life; quality of life as the aim of health care; and quality oflife as the determining factor to place a value on a human life. The studyindicates that the concept of quality of life had to undergo a natural andunavoidable development and expansion to keep pace with the changed medicalethos of our times. The writer indicates that the transformation of quality of life asthe aim of healthcare to quality of life as the factor for determining the value of alife is currently ethically unacceptable in its application. Finally, a moreacceptable development that includes referred competition and socialresponsibility is suggested.

[发布机构] Stellenbosch University