A quality-of-life study of elderly American patients found that they preferred living as long as possible in the state of health they were in rather than a shorter life in excellent health.
An article in the Journal of the American Medical Association said patients, or their relatives or guardians, were asked whether the patients would prefer living one year in their current state of health or less time in excellent health.
According to Dr Joel Tsevat of the University of Cincinnati Medical Centre (UCMC) of Ohio, they found only a modest correlation between health values and quality of life. "Although only 30 per cent of patients rated their current quality of life as excellent or very good, over 68 per cent were willing to give up, at most, one month of 12 in exchange for excellent health."
Similar attitudes have been experienced in Ireland by the Professor of Medical Gerontology in Trinity College, Dr Davis Coakley. "At different ages you have a different scale of values. To young people it may be very important to be actively involved in sport. An older person may be happier to listen to music."
He said it was important when measuring quality of life that an individual approach was taken with each patient. "Doctors and those involved in caring for people must not rush in and make dramatic decisions. The phrase `quality of life' is bandied about without people realising what is involved," said Prof Coakley. "As a society we have to come to terms with the fact that old age has its own value, just as childhood is a valued part of life."
The interviews carried out at the UCMC were conducted about four days after the patients were hospitalised and again 12 months later. Over 400 patients aged 80 and older were questioned, and 300 nominated decisions-makers for the patients.
At the other end of the spectrum, 6 per cent of the patients were willing to live two weeks or less in excellent health, rather than one year in their current state of health.
The researchers also found surrogate decision-makers were not always aware of the patients' preferences. "Patients were willing to trade significantly less time for a healthy life than their surrogates assumed they would."
The study also found patients willing to trade less time for better health were more likely to want resuscitation and other measures to extend life. When surviving patients were questioned again one year later, they were willing to trade less time for better health than at the beginning of the study.
The study's authors urge doctors treating elderly people to assess the health values of their individual patients when deciding to pursue aggressive medical care.