- Which are the fundamental goals of medical treatment and health care? Two common answers to this question are "good health" and "a high quality of life", respectively. These approaches are scrutinised from a conceptual and value-theoretical point of view, and an attempt is made to formulate an alternative, integrative answer.
- Supposing that an answer has been found to the above question: can we quantify the variables which define the overriding goal, and how are they to be measured in clinical practice? Can health and quality of life be quantified, and if so, on which kinds of scales? Are interpersonal comparisons of health status or quality of life possible? Do our "Quality of Life" instruments really measure the dimension which we want them to measure? The logical and philosophical arguments about these topics are integrated with studies of existing outcome scales used in the treatment of severe epilepsy.
- How are the health care resources to be distributed? Even supposing that we have determined the fundamental goals of epilepsy treatment and that we can make quantitative estimates of the effects of different treatments in terms of health, quality of life and other relevant variables, the moral problem of a just distribution of resources remains. The problem is of course highly relevant in the context of epilepsy surgery, which is an effective but costly method.
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