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Patients' and Families' Preferences for Medical Intensive Care

Donald L. Patrick, PhD, MSPH; Marion Danis, MD; Leslie I. Southerland, MPH
JAMA. 1989;261(2):242-243. doi:10.1001/jama.1989.03420020094019.
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To the Editor.—  We are responding to several editorial comments by Dr Zweibel1 about our study of patients' and families' preferences for medical intensive care.2 First, she states that the question that the research addresses was to what extent quality-of-life judgments should be applied in decision making for incompetent patients when no advance directive exists. In fact, we set out to determine to what extent quality of life predicts patients' treatment preferences. We found that quality of life was a poor predictor of patient preference for intensive care. We do not conclude from this, however, that quality of life is irrelevant to the treatment decision, but rather that it is not a simple matter to extrapolate from quality of life to treatment preferences.Second, Dr Zweibel is concerned about the method used to measure quality of life. It is important to note that the Perceived Quality of Life

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