Towards Self-Determination in Quality of Life Research: A Dialogic Approach

Med Health Care Philos. 2010 Feb;13(1):67-76. doi: 10.1007/s11019-009-9195-x. Epub 2009 Mar 10.


Health-related quality of life measures aim to assess patients' subjective experience in order to gauge an increasingly wide variety of health care issues such as patient needs; satisfaction; side effects; quality of care; disease progression and cost effectiveness. Their popularity is undoubtedly due to a larger initiative to provide patient-centered care. The use of patient perspectives to guide health care improvements and spending is rooted in the idea that we must respect patients as self-determining agents. In this paper I look at the two main orientations to quality of life measurement: standardized and individualized measures. I argue that while these measures are attempts to provide for patient self-determination, they both fail to do so. In their place I suggest a new approach which overcomes their respective difficulties: a dialogic approach.

MeSH terms

  • Humans
  • Patient Participation
  • Personal Autonomy*
  • Philosophy, Medical
  • Quality of Life*
  • Research Design*