Is there such a thing as a life not worth living?

摘要

There are no quality of life measures that reliably identify patients who feel that life is not worth living. Basing management decisions on such measures requires extreme caution because of the fluctuating nature of patients' valuations of life and their desire for death. Patients who are dying may find some quality in life, even when their quality of life as assessed by current measures is abysmal. The use of proxies to determine whether a life is worth living is problematic because of the possible disparity between an observer's assessment and the patient's own valuation. Both patients and their proxies have identified health states that they consider to be worse than death.