Quality of life: individualism or holism? A critical review of the literature.

For persons with mental handicaps or with other disabilities, quality of life (QOL) as a subject of inquiry is closely linked with the principle of integration. A critical review of the literature presented in this paper shows that (1) studies of QOL follow a sharp dichotomy between subjective and objective approaches, and that (2) QOL as a phenomenon does not lend itself to dichotomies but calls for a holistic approach. Selected studies which have opted for a transcendental approach are also discussed and were found to fall short of developing a holistic approach. This study contends that the prevalence of the notion of the individual as a distinct and autonomous being has forestalled attempts to construct a holistic model of QOL. In this paper, QOL is understood in terms of dynamic integration of the individual into the society. This insight emerges from a discussion of rituals which highlights the point that integration is a complex process requiring continual regeneration of individuals as well as society.