Skip to main content
Log in

Quality of Life Considered as Well-Being: Views from Philosophy and Palliative Care Practice

  • Published:
Theoretical Medicine and Bioethics Aims and scope Submit manuscript

Abstract

The main measure of quality of life is well-being. The aim of this article is to compare insights about well-being from contemporary philosophy with the practice-related opinions of palliative care professionals. In the first part of the paper two philosophical theories on well-being are introduced: Sumner’s theory of authentic happiness and Griffin’s theory of prudential perfectionism. The second part presents opinions derived from interviews with 19 professional palliative caregivers. Both the well-being of patients and the well-being of the carers themselves are considered in this empirical exploration. In the third part the attention shifts from the description of “well-being” to prescriptions for the promotion of well-being. Our interview data are analysed in light of the theories of Sumner and Griffin for clues to the promotion of “well-being.” The analysis (1) underscores the subject-relativity of well-being, (2) points out that values that are considered important in every life still seem to be relevant (at least in palliative care practice), and (3) shows the importance of living a certain sort of life when aiming to enhance dying patients’ well-being.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • J. Annas (2002) Should Virtue Make You Happy? Lawrence Jost Roger Shiner. (Eds) Eudaimonia and Well-being Academic Printing and Publishing Kelowna BC 1–19

    Google Scholar 

  • H. Buijssen R. Bruntink H. Ploeg Particlevan der F. Baar A. Stoppelenburg (2003) A Good Ending, Good for All? Care for Carers Working in Palliative Care De Stiel/TRED Nijmegen/Tilburg

    Google Scholar 

  • I Byock (2003) ArticleTitleRediscovering Community at the Core of the Human Condition and Social Covenant Hastings Center Report 33 IssueIDSuppl s40–s41

    Google Scholar 

  • J.F. Deeken K.L. Taylor P. Mangan K.R. Yabroff J.M. Ingham (2003) ArticleTitleCare for the Caregivers: A Review of Self-report Instruments Developed to Measure the Burden, Needs, and Quality of Life of Informal Caregivers Journal of Pain and Symptom Management 26 922–953 Occurrence Handle10.1016/S0885-3924(03)00327-0 Occurrence Handle14527761

    Article  PubMed  Google Scholar 

  • D. Doyle G. Hanks N. Cherny K. Calman (Eds) (2003) Oxford Textbook of Palliative Medicine 3rd ed Oxford University Press Oxford

    Google Scholar 

  • E.J. Emanuel L.L Emanuel (1998) ArticleTitleThe Promise of a Good Death The Lancet 351 IssueIDSuppl II S21–S29 Occurrence Handle10.1016/S0140-6736(98)90329-4

    Article  Google Scholar 

  • J Griffin (1986) Well-Being: Its Meaning, Measurement and Moral Importance Clarendon Press Oxford

    Google Scholar 

  • S.C. Hull H.A. Taylor N.E. Kass (2001) Qualitative Methods Jeremy Sugarman Daniel Sulmasy (Eds) Methods in Medical Ethics Georgetown University Press Washington 146–168

    Google Scholar 

  • R.S. Katz B. Genevay (2002) ArticleTitleOur Patients, Our Families, Ourselves: The Impact of the Professional’s Emotional Responses on End-of-life Care American Behavioral Scientist 46 327–339 Occurrence Handle10.1177/000276402237767

    Article  Google Scholar 

  • J Lawton (2000) The Dying Process: Patient’s Experiences of Palliative Care Routledge London

    Google Scholar 

  • K.A. Luker L. Austin A. Caress C.E. Hallett (2000) ArticleTitleThe Importance of ȁ8Knowing the Patient’: Community Nurses Constructions of Quality in Providing Palliative Care Journal of Advanced Nursing 31 775–782 Occurrence Handle10.1046/j.1365-2648.2000.01364.x Occurrence Handle10759973

    Article  PubMed  Google Scholar 

  • G.W Martin (1998) ArticleTitleEmpowerment of Dying Patients: The Strategies and Barriers to Patient Autonomy Journal of Advanced Nursing 28 737–744 Occurrence Handle10.1046/j.1365-2648.1998.00710.x Occurrence Handle9829661

    Article  PubMed  Google Scholar 

  • T.R. McCormick B.J Conley (1995) ArticleTitlePatients’ Perspectives on Dying and on the Care of Dying Patients Western Journal of Medicine 163 IssueIDspecial issue: Caring for Patients at the End of Life 236–243 Occurrence Handle7571586

    PubMed  Google Scholar 

  • D.E. Meier A.L. Back R.S. Morrison (2001) ArticleTitleThe Inner Life of Physicians and Care of the Seriously Ill Journal of the American Medical Association 286 3007–3014 Occurrence Handle10.1001/jama.286.23.3007 Occurrence Handle11743845

    Article  PubMed  Google Scholar 

  • M.B. Miles A.M. Huberman (1994) Qualitative Data Analysis: An Expanded Sourcebook SAGE Publications Thousand Oakes

    Google Scholar 

  • A.W Musschenga (1997) ArticleTitleThe Relation Between Concepts of Quality-of-Life, Health and Happiness The Journal of Medicine and Philosophy 22 11–28 Occurrence Handle9095459

    PubMed  Google Scholar 

  • L Nordenfelt (1993) Quality of Life, Health and Happiness Ashgate Aldershot, UK, Burlington, VT

    Google Scholar 

  • L Nordenfelt (1999) ArticleTitleIntroduction Ethical Theory and Moral Practice 2 3–10 Occurrence Handle10.1023/A:1026493415021

    Article  Google Scholar 

  • G. Olthuis W. Dekkers (2003) ArticleTitleMedical Education, Palliative Care and Moral Attitude: Some Objectives and Future Perspectives Medical Education 37 928–933 Occurrence Handle10.1046/j.1365-2923.2003.01635.x Occurrence Handle12974850

    Article  PubMed  Google Scholar 

  • R.A. Pearlman S.H. Miles R.M. Arnold (1993) ArticleTitleContributions of Empirical Research to Medical Ethics Theoretical Medicine 14 197–210 Occurrence Handle10.1007/BF00995162 Occurrence Handle8259527

    Article  PubMed  Google Scholar 

  • A. Ramirez J. Addington-Hall M. Richards (1998) ArticleTitleABC of Palliative Care: The Carers British Medical Journal 316 208–211 Occurrence Handle9468691

    PubMed  Google Scholar 

  • J Richardson (2002) ArticleTitleHealth Promotion in Palliative Care: The Patients’ Perception of Therapeutic Interaction with the Palliative Nurse in the Primary Care Setting Journal of Advanced Nursing 40 432–440 Occurrence Handle10.1046/j.1365-2648.2002.02391.x Occurrence Handle12421402

    Article  PubMed  Google Scholar 

  • L Sandman (2001) A Good Death: On the Value of Death and Dying Acta Philosophica Gothoburgensia Göteborg

    Google Scholar 

  • P Sandøe (1999) ArticleTitleQuality of Life – Three Competing Views Ethical Theory and Moral Practice 2 11–23 Occurrence Handle10.1023/A:1026404014630 Occurrence Handle15015520

    Article  PubMed  Google Scholar 

  • M Schermer (2001) The Different Faces of Autonomy: A Study on Patient Autonomy in Ethical Theory and Hospital Practice Dissertation University of Amsterdam Amsterdam

    Google Scholar 

  • M Schermer (2003) ArticleTitleIn Search of 'The Good Life’ for Demented Elderly Medicine, Health Care and Philosophy 6 35–44

    Google Scholar 

  • D.W Sherman (1999) ArticleTitleEnd-of-life Care: Challenges and Opportunities for Health Care Professionals The Hospice Journal 14 109–121 Occurrence Handle10.1300/J011v14n03_08 Occurrence Handle10839005

    Article  PubMed  Google Scholar 

  • P.A. Singer D.K. Martin M. Kelner (1999) ArticleTitleQuality End-of-life Care. Patients’ Perspectives Journal of the American Medical Association 281 163–168 Occurrence Handle10.1001/jama.281.2.163 Occurrence Handle9917120

    Article  PubMed  Google Scholar 

  • K.E. Steinhauser N.A. Christakis E.C. Clipp M. McNeilly L. McIntyre J.A. Tulsky (2000) ArticleTitleFactors Considered Important at the End of Life by Patients, Family, Physicians, and Other Care Providers Journal of the American Medical Association 284 2476–2482 Occurrence Handle10.1001/jama.284.19.2476 Occurrence Handle11074777

    Article  PubMed  Google Scholar 

  • D.P. Sulmasy J. Sugarman (2001) The Many Methods of Medical Ethics (Or, Thirteen Ways of Looking at a Blackbird) Jeremy Sugarman Daniel Sulmasy (Eds) Methods in Medical Ethics Georgetown University Press Washington 3–18

    Google Scholar 

  • L.W. Sumner (2002) Happiness Now and Then Lawrence Jost Roger Shiner (Eds) Eudaimonia and Well-Being Academic Printing and Publishing Kelowna BC 21–39

    Google Scholar 

  • L.W Sumner (1996) Welfare, Happiness, and Ethics Oxford University Press Oxford

    Google Scholar 

  • R.G Twycross (1987) ArticleTitleQuality Before Quantity – A Note of Caution Palliative Medicine 1 65–72

    Google Scholar 

  • J Varelius (2003) ArticleTitleAutonomy, Subject-Relativity, and Subjective and Objective Theories of Well-Being in Bioethics Theoretical Medicine 24 363–379 Occurrence Handle10.1023/B:META.0000006908.26112.fe

    Article  Google Scholar 

  • E.K. Vig R.A. Pearlman (2004) ArticleTitleGood and Bad Dying from the Perspective of Terminally Ill Men Archives of Internal Medicine 164 977–981 Occurrence Handle10.1001/archinte.164.9.977 Occurrence Handle15136306

    Article  PubMed  Google Scholar 

  • G Walters (2004) ArticleTitleIs There Such a Thing as a Good Death?” Palliative Medicine 18 (2000) 404––408 Occurrence Handle10.1191/0269216304pm908oa

    Article  Google Scholar 

  • Wenrich, M.D., J.R. Curtis, D.M. Ambrozy, J.D. Carline, S.E. Shannon, and P.G. Ramsey. “Dying Patients’ Need for Emotional Support and Personalized Care from Physicians: Perspectives of Patients with Terminal Illness, Families, and Health Care Providers.” Journal of Pain and Symptom Management 25 (2003): 236–246

    Google Scholar 

  • D.M Wilson (2000) ArticleTitleEnd-of-Life Care Preferences of Canadian Senior Citizens with Caregiving Experience Journal of Advanced Nursing 31 1416–1421 Occurrence Handle10.1046/j.1365-2648.2000.01456.x Occurrence Handle10849154

    Article  PubMed  Google Scholar 

  • World Health Organization. “Palliative Care.” [cited (2004) Jan 12]. Available from: URL: http://www.who.int/cancer/palliative/en/

  • R. Yurk D. Morgan S. Franey J.B. Stebner D. Lansky (2002) ArticleTitleUnderstanding the Continuum of Palliative Care for Patients and Their Caregivers Journal of Pain and Symptom Management 24 459–470 Occurrence Handle10.1016/S0885-3924(02)00503-1 Occurrence Handle12547046

    Article  PubMed  Google Scholar 

  • C. Zimmerman (2004) ArticleTitleDenial of Impending Death: A Discourse Analysis of the Palliative Care Literature Social Science and Medicine 59 1769–1780 Occurrence Handle10.1016/j.socscimed.2004.02.012 Occurrence Handle15279932

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gert Olthuis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Olthuis, G., Dekkers, W. Quality of Life Considered as Well-Being: Views from Philosophy and Palliative Care Practice. Theor Med Bioeth 26, 307–337 (2005). https://doi.org/10.1007/s11017-005-4487-5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11017-005-4487-5

Keywords

Navigation