Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
To the Editor.—Drs Leplége and
Hunt1 are correct to question the current
use of quality-of-life assessment. In practice, quality-of-life questionnaires
are all, in one form or another, complaint checklists, and when quality of
life is measured in this way, the concept becomes equivalent to absence of
health complaint. Is quality of life really just the absence of complaint?
As in Aesop's fable of the fox and the sour grapes, people change their goals
when they find those goals to be unattainable. The gap between desire and
attainment can be reduced as much by a diminution of desire as it can be by
increased functional attainment, although whether it is good to attenuate
desire is a value judgment. Contrary to what Leplége and Hunt say,
quality-of-life scales do not measure functional ability, they measure willingness
to complain about perceived functional disability.
Hyland ME. Defining and Measuring Quality of Life in Medicine. JAMA. 1998;279(6):429-431. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-6-jac81007