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March 5, 1982

Therapeutic choices not always predictable

JAMA. 1982;247(9):1231-1235. doi:10.1001/jama.1982.03320340005002

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A symposium on medical technology held during the recent meeting of the American Association for the Advancement of Science (AAAS) in Washington, DC, brought forth some new and somewhat surprising information.

For example, when evaluating the use of different therapies in clinical practice, patient values must be considered.

Thus, some patients, when choosing between two therapies for the same condition, prefer treatment that prolongs life but compromises its quality, while others prefer the opposite, said Barbara J. McNeil, MD, PhD, associate professor of radiology, Harvard Medical School, Boston.

She cited a study of healthy firefighters and business executives, in which 8% of the firefighters and 24% of the executives, confronted with a hypothetical situation involving cancer of the larynx, chose treatment that would preserve their ability to speak at the expense of lengthened survival (N Engl J Med 1981;305:982-987). But "the medical profession has decided that this is the column