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Marion Danis, MD; Donald L. Patrick, PhD; Leslie I. Southerland, MPH; Michael L. Green, MD

JAMA. 1988;260(6):797-802.

Abstract
Medical ethics suggest that life-sustaining treatment decisions should be made with consideration for patients' preferences and quality of life. Patients were interviewed who were at least 55 years old and had experienced medical intensive care at a university hospital during a one-year period to determine their preferences regarding intensive care; family members were interviewed if the patient had died (n = 160). Seventy percent of patients and families were 100% willing to undergo intensive care again to achieve even one month of survival; 8% were completely unwilling to undergo intensive care to achieve any prolongation of survival. Preferences were poorly correlated with functional status or quality of life and were not altered by life expectancy for 82% of respondents. Age, severity of critical illness, length of stay, and charges for intensive care did not influence willingness to undergo intensive care. These data suggest that personal preferences may conflict with any health policy that limits the allocation of intensive care based on age, function, or quality of life.

(JAMA 1988;260:797-802)

Author Affiliations
From the Departments of Medicine (Dr Danis and Ms Southerland) and Social and Administrative Medicine (Dr Patrick) and the School of Medicine (Dr Green), University of North Carolina, Chapel Hill. Dr Patrick is now with the Department of Health Services, University of Washington, Seattle. Dr Green is now with the Department of Medicine, Beth Israel Hospital, Boston.

Footnotes
Reprint requests to Division of General Medicine and Clinical Epidemiology, Department of Medicine, 5025A Old Clinic Building, CB 7110, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514 (Dr Danis).

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