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February 11, 1998

Defining and Measuring Quality of Life in Medicine

Author Affiliations

Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998

JAMA. 1998;279(6):429-431. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-6-jac81007

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.

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