Abstract

In “ReImagining the Quality of Life,” Lorraine Besser challenges the frameworks typically used for evaluating the quality of people’s lives, especially those with Alzheimer’s disease or those in minimally conscious states (MCS). These frameworks rely on two standards: agency and sentience. The first assumes that the absence of agency makes a life prudentially worthless (worthless to the individual whose life it is), because cognitive activity is prudentially valuable “only when it reflects agency;” whereas the second assumes that the absence of pleasure makes a life prudentially worthless, because pleasure is the only experiential value. Besser argues, however, that cognitive engagement with an activity or experience that a patient finds interesting is also prudentially valuable, even if it doesn’t reflect agency, and even if it isn’t pleasurable. The interesting “describes a qualitative aspect of our experience of a robust form of cognitive engagement, which resonates with us in a fashion similar to pleasure.” Besser’s view is an important contribution to the literature on the quality of life, and to the lives of patients with Alzheimer’s or MCS. However, I challenge Besser’s view that interesting experiences need not have a positive resonance to such patients, even though they are similar to pleasure.