A major theme of this novel is quality of life. Quality of life is defined for most people as the ability to live a fulfilling life, such as participating in relationships and the ability to make a living. For people with handicaps this definition becomes more narrowly defined, such as reducing it to the ability to aid in one's day-to-day needs. With children like Shawn, the focus is less exact, leaving the issue of quality of life up to debate. Shawn cannot participate in a relationship, nor ever hope to be capable of making a living. Shawn cannot participate in his own care. Shawn cannot talk, cannot walk, and cannot focus on an object at will. Shawn has no control over all the bodily functions that would allow him to interact with the world. To most people, including his father, Shawn is a vegetable.