By Max J. Charlesworth
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Medically speaking, a patient's quality of life may be poor, but morally or personally speaking the patient's quality of life may be very rich in terms of the way she has made an autonomous life for herself despite her physical handicaps. In this sense people's quality of life or human happiness depends upon what they make of the often unpromising circumstances in which they find themselves. In the Nicomachean Ethics 31 Aristotle says, rather oddly, that King Priam in Homer's Iliad cannot be accounted 'happy' because of the calamities that came upon him in his old age.
The worth, value or quality of my life cannot be measured 'objectively' (as my physical condition can) without reference to what I choose to do, as an autonomous moral agent, with my life. That is why any utilitarian account must be inadequate, since a person's life cannot be estimated in terms of measurable pain and suffering, or dissatisfaction outweighing or being outweighed by measurable benefits or satisfactions, but rather of whether or not some point or moral significance can possibly be given to, or made out of, the pain and suffering.
15 Since our dominant culture is one based upon the liberal value of individual autonomy, it is hardly surprising that no one now recognises or accepts that there is a socially imposed and traditionally sanctioned 'right way to die' which allows no scope for choice in the way one dies. Indeed, one might say that it is not only not surprising but also not regrettable, since it marks progress in moral consciousness when one has a right to control and choose the way one dies in the same way that one controls and chooses the way one lives.