To the Editor.
—I certainly agree with Dr Wetle1 that age per se should never be a reason to withhold treatment. However, age must be taken into consideration in assisting our patients to make rational judgments about therapy. The reason for this has to do with the fact that most therapies, especially surgical therapies, carry an immediate risk of death. For a younger person, this may be acceptable if the years of life to be gained or the improvement in quality of life is great enough that they are valued more by the patient than the immediate risk of death. Older patients, because their life expectancy is decreased, always have less to gain (if the valued outcome is years of life) than younger persons. This is compounded by the fact that the risks of surgical procedures or other therapies are often greater in the elderly than in the young.
Desbiens NA. Age as a Risk Factor for Inadequate Treatment. JAMA. 1988;259(1):41. doi:10.1001/jama.1988.03720010021012