The Quality of Quality-of-Life Measurements-Reply

In Reply. —We appreciate the interest generated by the article by Drs Gill and Feinstein and by our Commentary. In particular, we share the viewpoint expressed by Dr Hürny and colleagues and Drs Perneger and Hudelson that empirical tests of key measurement properties are required for confidence in health-related quality-of-life (HRQL) ratings.Apparently, Dr Madorsky feels that we should not describe an accident in which a previously healthy individual becomes paraplegic as a calamity or a tragedy, nor should we acknowledge that such an event entails suffering. To us, this seems denying the obvious and contradicts our experience with many individuals and families.Society continues to discriminate against disabled people. Lack of wheelchair access in many public and private institutions is the most obvious form of what is a tendency to ignore the needs of the disabled and to peripheralize and stigmatize them. We understand that Dr Madorsky believes she