Phillips Catherine R
Faculty of Health and Behavioural Sciences, Lakehead University, Canada.
J Aging Stud. 2018 Mar;44:9-14. doi: 10.1016/j.jaging.2017.11.001. Epub 2017 Nov 17.
'Quality of life' (QoL) is a ubiquitous phrase in medicine. There is considerable literature on the meaning of 'quality' in 'quality of life', but little on the meaning of 'life'. And yet, rooted in measurements of QoL, is a conceptualization of 'a life' used to judge 'quality'. In this article I focus on 'life' within institutional healthcare, arguing that for patients who are considered elderly, their life is defined against functionality. I use an autoethnographic method to enter this conversation, underlining the disjuncture between patients' understanding of 'a life', and that of healthcare professionals. I draw on the writings of the Italian philosopher Georgio Agamben to interrogate 'life', shifting the conversation of QoL from one of measurement and administration to one of political order. I discuss both the formal, evidence-based tools and the nature of their application. I conclude by arguing that QoL tools and their application, produce a particular kind of life, and that what is at stake in the invocation of 'quality of life' in health care is our very experience of aging and our embodiment.
“生活质量”（QoL）在医学领域是一个常用词汇。关于“生活质量”中“质量”的含义已有大量文献，但关于“生活”的含义却鲜有探讨。然而，在生活质量的衡量中，蕴含着一种用于评判“质量”的“生活”概念。在本文中，我聚焦于机构化医疗环境中的“生活”，认为对于被视为老年人的患者而言，他们的生活是以功能为参照来界定的。我采用自我民族志方法参与这场讨论，强调患者对“生活”的理解与医疗专业人员的理解之间的脱节。我借鉴意大利哲学家乔治·阿甘本的著作来审视“生活”，将生活质量的讨论从测量与管理层面转向政治秩序层面。我探讨了基于证据的正式工具及其应用的本质。我的结论是，生活质量工具及其应用塑造了一种特定类型的生活，而在医疗保健中提及“生活质量”所涉及的关键问题是我们对衰老的体验以及我们的身体存在。
