Quality of Life and the Statistical Outlier: On Caring in an Industrialized Age

To excavate the different contemporary meanings of the term quality of life, this study queries the role of communication in diagnosis and treatment, especially of mentally disabled patients. It addresses the relative weightings given in medicine today to the stories told by patients about their health (the communicative aspect of the physician-patient relationship), to the body of the patient (the Hippocratic tradition of listening to the body), and the modern tradition of medicine as observing and altering bodily parts (the systemic view of health care). Empirical evidence is surveyed that indicates barriers to responsive healthcare delivery to people with severe learning difficulties are not simply infrastructural problems but are intrinsically related to the contemporary configuration of medical knowledge. The discussion concludes by indicating how—if the dilemmas generated by modern medical institutions are an artifact of the self-definition of the actors within them—the Christian tradition can be understood to offer a rival mode of knowing the body that revives listening as a constitutive aspect of medical caring.