Most Terminal AIDS Patients Want to Be Revived if Their Heart Stops

For persons with AIDS, current health status does not necessarilyaffect their desire to be revived if their heart stops, accordingto a study supported by the Agency for Health Care Policy andResearch (HS06239).

About 65% of terminally ill AIDS patients in this study, mostlyyoung homosexual and bisexual men, wanted to be revived if theirheart stopped. Overall, those who considered themselves to bein the best health were more likely to want to be revived. However,over half of those who considered their health to be the veryworst (the lowest quartile) also wanted to be resuscitated.

A key finding was that the relationship between health statusand desire for resuscitation does not hold up for all patients.For the third of patients who expressed the most reluctance togive up life, by saying that they wanted life extension even ifit meant living in some undesirable state (such as being blindor fed by a tube), current health status was unrelated to desirefor resuscitation.

These results suggest limits to the validity of assessing howa patient values his or her current health status by asking questionsthat involve loss or risk of life, such as "standard gambles"(for example, what risk the patient is willing to take of dyingin surgery to cure a health problem) and time trade-off questions(for example, how many years of later life a person is willingto give up for better life now). A general reluctance to giveup life may confound how patients answer such questions, notesArnold Epstein, md, of Harvard Medical School. These findingsare based on interviews of 291 patients with AIDS who participatedin the Boston Health Study during 1990 and 1991.

For more information, see "The Role of Reluctance to GiveUp 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):195-200,1995].