For persons with AIDS, current health status does not necessarily
affect their desire to be revived if their heart stops, according
to a study supported by the Agency for Health Care Policy and
About 65% of terminally ill AIDS patients in this study, mostly
young homosexual and bisexual men, wanted to be revived if their
heart stopped. Overall, those who considered themselves to be
in the best health were more likely to want to be revived. However,
over half of those who considered their health to be the very
worst (the lowest quartile) also wanted to be resuscitated.
A key finding was that the relationship between health status
and desire for resuscitation does not hold up for all patients.
For the third of patients who expressed the most reluctance to
give up life, by saying that they wanted life extension even if
it meant living in some undesirable state (such as being blind
or fed by a tube), current health status was unrelated to desire
These results suggest limits to the validity of assessing how
a patient values his or her current health status by asking questions
that involve loss or risk of life, such as "standard gambles"
(for example, what risk the patient is willing to take of dying
in surgery to cure a health problem) and time trade-off questions
(for example, how many years of later life a person is willing
to give up for better life now). A general reluctance to give
up life may confound how patients answer such questions, notes
Arnold Epstein, md, of Harvard Medical School. These findings
are based on interviews of 291 patients with AIDS who participated
in the Boston Health Study during 1990 and 1991.
For more information, see "The Role of Reluctance to Give
Up Life in the Measurement of the Values of Health States,"
by Floyd J. Fowler, Jr., phd, Paul D. Cleary, phd, Michael P.
Massagli, phd, et al in Medical Decision Making [15(3):195-200,