Home  Publications 20 Years Special Edition IS QoL a COA? |
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Page 5 of 8 Here again, this has resulted in an increase in administrative work that practitioners must undergo and undertake in order to allow patients to claim reimbursement from overweening providers of medical insurance.
Other Developments
These examples are inimical to the critical examination of the subjective. The effects of other contemporary developments are even more difficult to investigate. Among them are such important changes in teaching as the development of interdisciplinary modules and distance learning, clearly desirable for underprivileged communities, although medically qualified parents are becoming less likely to advise their offspring to follow them.
Influences from the information revolution are especially important but hard to predict. They already affect patients, doctors, the pharmaceutical industry and regulatory authorities, and will continue to do so more and more profoundly. Among patients, Expert Patient, Self-Help and other Support Groups. They are made possible by the exploding use of social networking or the individual development of so-called multitasking that these also make possible.8 On the other hand, the overall increase of Total Data Collection (e.g., by Google and Klout), may dehumanize us all yet further; or it may turn out to be beneficial.
Whether any of these developments will improve or further impede the study of QoL,however, will depend upon whether the
next cycle will favor the development of more sophisticated methods of studying subjectivity. There seem to be few signs of such movement,9 although the work of Damasio is a notable exception.10
Drug regulatory authorities, such as the American FDA and European EMA continually increase their demands for information about new entrants to the market, as well as existing products. These have included, until recently, insistence on studies of “QoL,” contributing to a volume of paper already too heavy to be adequately studied. The FDA, it must be admitted, is coming to pay less and less attention to claims about the effects of interventions upon QoL.
Meanwhile, the pharmaceutical industry, encouraged by increasing problems with regulatory control, will probably be able to
increase promotion of potentially dangerous off-label prescribing;11 sometimes, it must be admitted, serendipitously beneficial.
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