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To the Editor.—Dr Tsevat and colleagues'¹ examination of the health values of hospitalized elderly patients makes a valuable contribution to the efforts to improve end-of-life care. However, as is often the case when values are in question, the data they present could be used to formulate somewhat different conclusions, and the article raises as many questions as it answers. The authors' finding that "most patients were unwilling to trade much time for excellent health" could have been reported as "59.2% were willing to accept some shortening of life in exchange for better health." Moreover, the conclusions should be weighed with due consideration of the effect of acute hospitalization, which may have diminished subjects' willingness to consider hypothetical alternatives to recovery. Also, the methods do not permit readers to determine what proportion of patients who declined to "trade" quantity of life for quality of life actually might have been entirely . . . [Full Text of this Article]

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RELATED ARTICLE

Health Values of Hospitalized Patients 80 Years or Older
Joel Tsevat, Neal V. Dawson, Albert W. Wu, Joanne Lynn, Jane R. Soukup, E. Francis Cook, Humberto Vidaillet, Russell S. Phillips, and for the HELP Investigators
JAMA. 1998;279(5):371-375.
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