INTRODUCTION

There has been considerable philosophical work during the last two decades, especially in the United States but not limited to there, in a relatively new field called medical ethics. My aim in this essay is to explore what illumination that body of work might offer to our understanding of the quality of life. If one looks only to the medical ethics literature explicitly addressing the notion of the quality of life, there are few sustained analyses of it and of its role in various medical and health care contexts. Consequently, it is necessary to look more broadly to issues and areas of research that often do not explicitly address the quality of life, but that nevertheless have an important bearing on it. I believe there are two main areas of work in medical ethics that fit this criterion. The first is work on ethical frameworks for medical treatment decision-making in a clinical context, including accounts of informed consent and life-sustaining treatment decisions. The second is the development of valuational measures of outcomes of health care treatments and programs; these outcome measures are designed to guide health policy and so must be able to be applied to substantial numbers of people, including across or even between whole societies. The two main parts of this paper will address these two main bodies of work. Before doing so, however, several preliminary issues need to be briefly addressed.