To the Editor.
—In the introduction to their Commentary, Drs Guyatt and Cook1 reveal the powerful prejudices that have resulted in centuries of devaluation of the lives of persons with physical disabilities. While giving lip service to "Gill and Feinstein's2 message that people's values differ," Guyatt and Cook identify paraplegia as the epitome of a situation in which quality of life "would be rated low."Under the cloak of platitudes about the person who "transcends" loss to find "new meaning in life," the authors reinforce negative societal stereotypes about the "suffering," "calamity," and "tragedy" that they believe is the lot of the individual who is "paraplegic or even quadriplegic."Thus do they underscore the absolute necessity for critical appraisals of quality-of-life measurements, as advocated by Gill and Feinstein.2 For until the insidious assumption is challenged that the quality of life of an individual with a disability is
Madorsky JG. The Quality of Quality-of-Life Measurements. JAMA. 1995;273(11):844. doi:10.1001/jama.1995.03520350025016