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May 27, 1998

Health Values of Hospitalized Elderly Patients—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(20):1611-1612. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-20-jbk0527

In Reply.—Dr Gessert raises an interesting possible explanation for patients' reluctance to trade quantity of life for quality of life, namely, that patients may have been at peace with their mortality. Although we did not explore this phenomenon in this study, an alternative explanation is that patients may be at peace with the meaning and purpose of their "life,"1 and are, therefore, reluctant to give up time. In any case, we did not mean to imply that the questions we asked are scientific measures of the meaning of life and death; however, we do believe that understanding how elderly patients balance length and quality of life and their preferences for care sheds light on our efforts to understand the meaning and importance of life for our elderly patients. Importantly, readers should not infer from our findings regarding the will to live (or reluctance to postpone death) in their particular current state of health that patients would prefer quantity of life in any state of health, no matter how poor.

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