We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Health Values of Hospitalized Elderly Patients

Charles E. Gessert, MD
JAMA. 1998;279(20):1611-1612. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-20-jbk0527.
Text Size: A A A
Published online


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 at peace with their mortality, in whatever form and at whatever pace it would overtake them. Such individuals would appear, in the data and in the conclusions, as people who supported life extension regardless of quality of life, when they could represent an entirely different point of view: acceptance of the natural debility and loss of control that occurs at the end of life.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.