Despite its obvious appealandgrowingcurrency in discussions of health
policy and health care, the notion of quality of life raises a difficult conceptual
issue for health professionals and policy makers: what outcomes
(or types of outcomes) are connected closely enough with health to be
taken account of in assessing the impact of health interventions on quality
of life? Health care cannot be concerned with all aspects of life or
well-being without giving it an impossibly broad mandate. That is just
what theWorld Health Organization (WHO) appeared to have done in
1947, adopting a definition of “health” that made it virtually coextensive
with quality of life: health was “not merely the absence of disease,
but a state of complete physical, mental, and social well-being.”2 That
definition, which set no limits on the scope of health policy or health
care, was widely criticized and, though it remains a piece of interagency
political rhetoric, plays no scientific role today even at the WHO.
policy and health care, the notion of quality of life raises a difficult conceptual
issue for health professionals and policy makers: what outcomes
(or types of outcomes) are connected closely enough with health to be
taken account of in assessing the impact of health interventions on quality
of life? Health care cannot be concerned with all aspects of life or
well-being without giving it an impossibly broad mandate. That is just
what theWorld Health Organization (WHO) appeared to have done in
1947, adopting a definition of “health” that made it virtually coextensive
with quality of life: health was “not merely the absence of disease,
but a state of complete physical, mental, and social well-being.”2 That
definition, which set no limits on the scope of health policy or health
care, was widely criticized and, though it remains a piece of interagency
political rhetoric, plays no scientific role today even at the WHO.
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