The Quality of Survival in Response to Treatment

Abstract

THE KIND of life a patient lives is as important as the fact that he is living. Physicians seldom argue over this basic premise. The quality of life, after all, is the major reason there is a medical prefession—because pain, anxiety, and other forms of misery are not happily tolerated by mankind. Recently, as we have learned to use more aggressive therapy and to continue it with life-sustaining ancillary aids, criticism has been raised that aggressive treatment often ignores patient welfare in the interest of science. The criticism is that therapy that prolongs life at a great cost in suffering, hospitalization, and money is a failure, not a success. Therefore, it is essential that we grapple with a criterion of response to therapy that deals with quality of life, knowing in advance that such criteria do not lend themselves easily to measurement and that we will presumably end up with