Quality Of Life


Quality Of Life Essay, Research Paper

Introduction In this brief essay an attempt will be made to define what is meant by the termquality of life´. Additionally, this paper will also briefly examine the approaches to well-being, and also look into the most popular methods used to measure the quality of life. In studying the measurability of quality of life, the Swedish model for assessment of quality of life will also be briefly explored. Defining quality of life It is not easy to define the term quality-of-life. The term can be defined in the terms of financial or economic well-being , or it can be defined as citizenship rights and freedoms. It can also be defined as political empowerment, or in terms of human relations. Distributive justice in a society can also be used to define the concept. It can also be a measure of the health indicators and social capital in a society. It could be concerned with everything and anything under the sun that is determinant of the quality of lives people live. In order to determine the type of lives people live one has to understand the multitude of activities they are involved in. The problem of defining quality of life is aggravated by the complexities of life itself and it becomes very difficult to determine reliable indicators of quality of life (Nussbaum & Sen 1993). Quality of life is an all inclusive notion of life and living (Szalai 1980). In the literature one finds that the quality of life may also mean to include the ‘style of living´ . Style of living means the broad notion of the culture of living. In the words of Taylor it includes, ‘the complex whole which includes knowledge, belief, art, morals, law, customs, and any other capabilities and habits acquired by man as a member of society´ (Taylor 1898, Vol. I. p.1). In short, quality of life can be defined ‘as the individual´s state of life as reflected in his levels of needs and satisfactions vis-à-vis his environment´ (Onyemelukwe 1981, p. 75). APPROACHES TO THE MEASUREMENT OF QUALITY OF LIFE This section briefly examines the philosophical foundation of the concept of quality of life. Utilitarianism ‘Tracing the stream of Utilitarian thought from its sources, we may start with Hobbes (Leviathan 1651), whose fundamental ethical axiom is that right conduct is that which promotes our own welfare; and the social code of morals depends for its justification on whether or not it serves the wellbeing of those who observe it´. The basis of the philosophy of Utilitarianism is the principle of utility. Utility means the ability of an action to provide pleasure to individuals and its ability to please maximum number of people i.e. achieving the greatest good for the greatest number. The utility of any action, therefore, is determined on the criterion of the minimisation of pain and maximisation of pleasure resulting from it to the maximum number of people. Most utilitarian theories try to blend the scientific and the moralistic aspects of the government policies. The efforts of the utilitarian philosophers are guided by empirical investigation, hedonism i.e. subjective pursuit of anything bringing any kind of pleasure, and liberal thought on political affairs. The evaluation is to be based on felicific calculus i.e. a way of measuring pleasure and pain to determine the overall pleasure-pain relationship of an action in its constituency as a whole. By this felicific calculus, it was argued, that legislators and government officials will be able to tell whether a particular action will or will not be beneficial to the general public in terms of end results. Therefore if the quality of life is measured in the utilitarian tradition then the basis of such measurement is utility. The policy that provides utility to maximum number of people will be deemed to improve the overall quality of all and vice versa. In the words of one of its most distinguished advocates, John Stuart Mill, ‘the creed which accepts as the foundation of morals, utility or the greatest happiness principle, holds that actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness. By happiness is intended pleasure and the absence of pain; by unhappiness, pain and the privation of pleasure´ (Mill 1871, p. ii). This approach however has some very serious drawbacks. First of all it assumes that people will not act in their own self-interest, to maximise their own good or utility, and their actions will be directed at the maximisation of common good for the maximum number of people. This assumption is violated if we take people as rational-men, trying to maximise their utility through the various choices that they make. Additionally, the approach is based on the assumption that with maximisation of overall utility or good all will benefit equally, this does not appear true. Furthermore, the assertion that actions, as such, have no moral value, and what matters is their effect on the state of the world, does not appear plausible. To give an example, homicide, as per this argument, will not be intrinsically bad if it increases the overall utility. It seems hard to agree with this line of argument. Capabilities and the quality of life According to Sen quality of life a person is assessed by the capabilities that he has. Sen has defined capability as the ability to do something and to achieve certain functioning (Sen 1992). Functionings have been divided into four categories: well-being freedom, well-being achievement, agency freedom, and agency achievement. They contribute ‘directly to well-being, making one´s life richer with the opportunity of reflective choice´ (Sen 1992, p. 41). This approach is based on a view of living as a combination of various ‘doings and beings´, and the quality of life in determined by the capability to achieve functionings. This approach can be better explained with the help of an example that Sen has used in his Commodities and Capabilities (p. 76). Sen has shown that India and China have the same per capita income but are far apart in terms of the capabilities that the populations of both the countries have in terms of survival and education, such as ‘the ability to live long, the ability to avoid mortality during infancy and childhood, the ability to read and write, and the ability to benefit from sustained schooling. These capabilities are very important in the determination of quality of life, and income alone can not provide a valid measure of quality of life. Quality of life and primary goods Primary goods have been defined by John Rawls as the ‘things that every rational man is presumed to want´ (Rawls 1999, p. 54). To John Rawls (pp. 54 &348) social primary goods are: rights, liberties, opportunities, self-respect, income, and wealth; and natural primary goods are: health and vigour, intelligence and imagination. As per this approach, quality of life of a person can be assessed by the extent to which that person has been successful in obtaining the primary goods. ‘A man is happy when he is more or less successfully in the way of carrying out this plan´ (p.79). METHODS OF MEASUREMENT OF QUALITY OF LIFE There are a number of ways in which the quality of life is measured. This section will briefly examine some of the more popular measures of quality of life. GDP as the measure of quality of life GDP or Gross Domestic Produce is the most popular measurement of quality of life. An increasing Gross Domestic Product (GDP) is said to represent well-being and thus depicts an improvement in the quality of life. This indicator has been used increasingly since World War II. There are however some very serious problems with this method of measurement, which make one sceptical of the validity of this method in measuring quality of life. Some of the major drawbacks of using this method to measure quality of life are given below: ? Increasing GDP now seems to require cutting back on services which society has deemed worthy of support in the past. Education, health care, environmental protection, pensions, and anything else that does not directly produce monetary return are considered irresponsible expenditures in pursuit of well-being as represented by GDP. Furthermore, this measure treats all transactions in the economy as promoting quality of life, and does not distinguish between the transactions that improve quality of life and others that do not have this affect. ? GDP also ignores all that happens outside the realm of monetised exchange, regardless of its importance to well-being and quality of life. For example the crucial economic functions performed in the household and volunteer sectors go entirely ignored. ? As the measurement of quality of life through GDP records every monetary transaction as positive, the costs of social decay and natural disasters are also recorded as economic advance, in this method. Crime may add billions of pounds to GDP as increase in crime rate necessitates increased expenditure on police and security. In the same way a natural disaster causing billions of pounds loss of property is recorded in GDP as a boon to the economy to the same tune. Like wise divorce adds millions to GDP through lawyer´s fees, and the cost required for establishing a new household. ? GDP does not include the non-market economy of household and community. The important function of carers, and other household tasks performed are not accounted for in GDP measures. On the other hand in GDP are added the cost of prisons, social work, drug abuse and psychological counselling that arise from the neglect of the non-market realm. ? The GDP approach treats the depletion of natural capital as income, rather than as the depreciation of an asset. Resultantly, the more the nation depletes its natural resources, the more GDP goes up, and so does quality of life. ? This approach completely ignores the distribution of income in a country. If the increase in GDP only results in the increase in income of the top decile of the population then it would be wrong to conclude that the quality of life of the common peoples has improved. ? Income alone is not a good determinant of well-being or the quality of life. Some empirical studies found very weak correlation between income and happiness or satisfaction. Input and output measures Veenhoven (1992) has presented this model based on the input and output indicators of quality of life. Input indicators provide information on the presence of the living conditions deemed essential to provide for needs and capacities of the citizens. On the other hand, output indicators assess the degree to which people flourish in a society. The table on next page taken from Veenhoven work clearly depicts the input and output indicators.

Indicators of livability: summary scheme

__________________________________________________________________________ LIVABILITY

unobserved fit between provisions/requirements

concept of a society and needs/capacities of its citizens

INPUT indicators:OUTPUT indicators:

Presence in a society of livingFlourishing of citizens in

conditions deemed likely to fita society

with citizens’ needs/capacities,as apparent in:

observable- material affluenceHealth

manifestationssuch as:- social securityphysical health

– political freedom – longevity

cultural variety – me-ntal health-

– Etc….Satisfaction

– suicide

– alienation

– happiness ‘HAVING, LOVING AND BEING´ A SWEDISH MODEL FOR MEASURING QOL Two important and pioneering studies have been conducted in Sweden to measure quality of life. First one, called the Swedish Level of Living Survey was conducted in 1968 and the other a large-scale Scandinavian survey, conducted by the Research Group for Comparative Sociology at the University of Helsinki, in 1972. The focus of the Swedish Level of Living Survey was the concern of gauging the resources by means of which the people can control and master their lives. The level of living was defined as ‘the individual´s command over resources in the form of money, knowledge, mental and physical energy, social relations, security, and so on, through which the individual controls and consciously directs his living conditions´ (Erikson in Nussbaum & Sen 1993, pp. 72-73). In the comparative study the quality of life was assessed on the basis of basic-needs approach, developed by the Norwegian John Galtung (Allardt in Nussbaum & Sen 1993). The basic needs approach focuses on the conditions without which the human beings will be unable to survive, avoid misery, have social relationships, and avoid alienation in a social set up. Thus both material and non-material needs are considered in the basic needs approach to determine the quality of life. Having, loving and being refers to the approach adopted in the survey to determine the quality of life. ‘Having´ (Allardt 1993, p. 89) refers to the material conditions depicted by the following: ? ‘economic resources: income and wealth;

? housing conditions: measured both by space available and housing amenities;

? employment: usually described in terms of the occurrence or absence of unemployment;

? working conditions: noise and temperature at workplace, physical work routine, measures of stress;

? health: various symptoms (or their absence) of pain and illness, availability of medical aid, and

? education: years of formal education.´ ‘Loving´ refers to the need to be loved and to relate to other people in the society. As per Allardt (p. 91) the loving needs are as below: ? ‘attachment and contacts in the local community;

? attachments to family and kin;

? active patterns of friendship;

? attachments and contacts with fellow members in association and organisations, and

? relationships with work-mates´. ‘Being´ stands for the need for integration into the society that one is part of. There are two aspects to integration: on the positive side it is personal growth and on the negative side it is alienation. The indicators that measure the extent of integration in the society have been listed by Allardt (p. 91) as below: ? ‘to what extent a person can participate in decisions and activities influencing his life;

? political activities;

? opportunities for leisure-time activities;

? the opportunities for meaningful work life, and

? Opportunities to enjoy nature, either through contemplation or through activities such as walking, gardening, and fishing´. On the basis of the determinants of having, loving and being the quality of life is determined. Conclusion This paper has very briefly tried to explore the philosophical foundation of the concept of quality of life, and has also looked at some of the empirical approaches to the measurement of the concept. I would like to stress the need and the importance of looking at the quality of life in terms of the constituting components of a person´s life. This means to look separately into material well-being (physical and economic well-being), social well-being, and mental well-being. In my opinion, an approach that does not look into each of these aspects of the quality of life is essentially not complete. I would argue for looking into these aspects separately, rather then as a whole, so that one can find that which aspect of the quality of life is lacking, and therefore needs more focus by government in its policies. This is to say that if one has good quality of life as per one aspect it does not mean that the other aspects will also reflect the same quality. A rich person may have good quality of life in terms of material resources, but his business of making money may keep him too busy and thus the social quality of his life may be very poor, or his life may be too stressful. Additionally, in my view, quality of life is a relative concept. The judgement about one´s quality of life has to be with reference to the quality of life of other people in the community he is living. In assessing quality of life it is imperative that the social and economic development stage of a community is also taken into account. This is to say that same criteria can not be used to determine quality of life in a developed and a developing country. The reason for this is that the stage where most of the population of that community stands in the hierarchy of needs will determine the quality of life of that community. If the community has its basic physiological needs unsatisfied then it would be absurd to measure the quality of life in that community on the basis of self-actualisation or other higher level needs. In the same way in countries where basic needs have been satisfied, self-actualisation may form a useful basis for making assessment of quality of life. The concept of quality of life is as complex as life itself and its measurement is even more complicated. It might be easy to determine material well-being of a person, as it is easily quantifiable, but it might be very difficult to measure social well-being or mental well-being.

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