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Lecture for medical students in the
Medicine block King Fahad Medical City Riyadh on October 15, 2014
DEFINITION OF QUALITY OF LIFE
·
Human life must have some
quality. It is not enough to eat and breathe or maintain the vegetative
functions only. A human cannot live like a plant or an animal.
·
The physical criteria are:
absence of disease, comfortable environment, and basic necessities.
·
The mental criteria are:
calmness, absence of neurosis and anxiety, and purposive life.
·
The spiritual criteria are mainly
correct relation with the creator.
QUALITY OF LIFE and BIOTECHNOLOGY 1
·
Issues of quality of life have
been raised in the recent past because of advances in terminal disease care and
the stresses of technological development. Many patients who used to die of
cancer and other debilitating diseases can now survive.
·
Both the disease and its
treatment cause considerable changes to their lifestyle. The life under these
debilitating conditions is of low quality. Both the original disease and the
treatment contribute to this low quality; the treatment in some cases has a
more contribution.
QUALITY OF LIFE and BIOTECHNOLOGY 2
·
Specialized methods have been
developed to be able to assess the quality of this life empirically. These
indices take into considerations performance status on physical tasks in
addition to social or psychological parameters.
·
Industrial society has given rise
to environmental pollution and mental stress that affect the quality of life.
Decision-making on allocation of health care resources depends on quality of
life assessment.
TRADITIONAL MEASURES OF QUALITY OF LIFE
·
Traditional measures of the
quality of life use anatomical, chemical, and physiological indices. They
indicate general goals and are not good measures of actual quality of life.
Their interpretation is often subjective.
·
In cancer patients physical,
psychosocial and general assessments are made with reference to activities of
daily living (ADL).
·
Among traditional indices used
are: survival duration, impairments (signs, self-reported disease, physiological
measurements, tissue alterations, and diagnosis), and functional status
(physical, psychological, and social).
NEW MEASURES OF QUALITY OF LIFE 1
·
The new QOL indices are
predictors of the goals. They are based on instruments that are validated and
whose reliability is tested empirically. Some are general whereas others are
specific. Assessment of QOL may be by indices or by profiles; indices being
more popular.
·
The indices are standardized but
it must be remembered that each individual is unique.
NEW MEASURES OF QUALITY OF LIFE 2
The
indices used in clinical trials and clinical practice include.
·
McMaster Health Index
Questionnaire: physical, social, and emotional parameters
·
Index of Health-related Quality
of Life: physical, psychological, and social adjustment
·
Euroqol Quality Life Index:
mobility, self-care, usual activities, pain/discomfort, anxiety/depression
parameters
·
World Health Organization
Health-related Quality of Life (WHOQOL) is being developed.
NEW MEASURES OF QUALITY OF LIFE 3
The
commonest profiles of QOL used in clinical practice are:
·
Quality of Well-being Index:
combines morbidity and mortality parameters
·
Sickness Impact Profile: physical
and psychological dimensions
·
Nottingham Health Profile:
perceived health status with no direct questions on health
TOWARD AN ISLAMIC QOL INDEX
·
The definition and use of QOL
indices reflects the cultural and philosophical background as well as the
worldview of the Judeo-Christian and Greco-roman traditions.
·
Islam being a separate
civilization has its own world view and this affects the formulation of QOL
indices.
·
Unfortunately Muslims have not
yet worked on defining QOL from the Islamic context.
VALUE
OF LIFE
· Life as a gift
·
The right to life
·
Sanctity of life
·
Material worth of life
·
Moral worth of life
LIFE AS A GIFT 1
·
Human life is a gift from Allah, ni’imat al hayat[1].
Humans must be grateful to Allah for the gift of life by worshipping Him, ibadat[2]
·
The gift of life can be
appreciated from several vantage points: statistical probability, good health,
sustenance, and social relations.
·
The statistical probability of being alive is low. Those who have life
are a select few. A fertilized ovum that eventually grows into a human being is
a very small statistical probability. One male ejaculate has millions of sperms
and only one of them succeeds in fertilizing the female ovum. In many cases
fertilized ova do not grow into fetuses but are aborted early.
LIFE AS A GIFT 2
·
The prophet said that good
health, sihhat, and well-being, ‘aafiyat, are two bounties that many
people do not enjoy[3].
Few people are healthy in all their organs and at all times.
·
Allah gives humans the gift of
life and also gives them sustenance, rizq, is a manifestation of the
continuation of rububiyat.
·
Social aspects of life as a gift
can be visualized in the form of offspring, relatives and spouses. Children are
a bounty to parents, ni'mat al dhurtiyat[4].
Relatives in the extended family are a source of psychological support. Spouses
give both psychological and physical comfort[5].
THE RIGHT TO LIFE
·
Each human has an inalienable
right to life from Allah, haqq al hayat.
This life cannot be taken away or impaired by any human being except in cases
of judicial execution after due process of the law.
·
The laws of marriage ensure that
every child is born in a family in order to get physical protection.
·
Nafaqat is compulsory
for a pregnant and nursing woman even if divorced to ensure proper nutrition
for the fetus and later infant.
·
Breast-feeding is obligatory for
the first 2 years of life. Feticide, infanticide, and homicide are prohibited
to protect life.
SANCTITY OF LIFE
·
Life is sacred. The sanctity of
life, hurmat al nafs is guaranteed by
the Qur’an[6].
The life of each single individual whatever be his or her age, social status or
state of health is important and is as equally important as the life of any
other human[7].
·
Protection of life, ‘ismat al hayat/hifdh al nafs, is the second most important purpose of the shariat coming second only to the
protection of the diin. It has
priority over any other mundane consideration.
·
Because of its importance some
jurists have put it in the first position above hifdh al diin because diin cannot survive in the absence of life.
MATERIAL WORTH OF LIFE
·
No material value can be put on
human life.
·
Legal compensation for bodily
damage or homicide is replacement of lost earnings and not paying for the value
of life.
·
The compensation is a legal
provision to provide sustenance to surviving relatives in case of death. It
also provides sustenance to the person whose organ was severed and therefore
cannot work to support himself.
MORAL WORTH OF LIFE
·
Every life is as important as any
other life.
·
Destroying the life of one person
is equivalent to destroying the life of all humans[8].
REFERENCES