Explain the argument that quality of life is more important than quantity of life. What are the ethical and legal issues in support that quality of life is more important than quantity of life? Describe 2 patient situations, conditions, diagnoses where quality of life is clearly more important than quantity of life and what you would do in each.

Explain the argument that quality of life is more important than quantity of life.

Throughout our lives we heard of how quality is better than quantity, that taking the time to do something of high quality will always yield the best results. That the quality of your creative work is so much more important than the quantity of your creative work. Therefore, Quality of life measures are designed to enable patients' perspectives on the impact of health and healthcare interventions on their lives to be assessed and taken into account in clinical decision making and research unlike quantity of life.

What are the ethical and legal issues in support that quality of life is more important than quantity of life?

In an ethical perspective, preservation of Quality of life should be considered an important means to preserve a person's dignity, that is the ability to pursue his/her own unique mission. These   ethical an legal issues include patients' decision-making capacity and right to refuse treatment; withholding and withdrawing life-sustaining treatment, including nutrition and hydration; "no code" decisions; medical futility; and assisted suicide. Implications for critical care practice, education, research and public policy are identified.

Describe 2 patient situations, conditions, diagnoses where quality of life is clearly more important than quantity of life and what you would do in each.
 

During the past decades there was an increasing predominance of chronic disorders, as a result of improved living conditions, better prevention, infectious diseases management, medical technological improvements and overall aging of the population. Therefore, an increasing number of people live with chronic diseases that can adversely affect their health-related quality of life . In general, chronic diseases are slow in progression, long in duration, and they require medical treatment. The majority of chronic diseases hold the potential to worsen the overall health of patients by limiting their capacity to live well, limit the functional status, productivity and health-related quality of life  and are a major contributor to health care costs. Among these diseases are cancer, heart diseases, stroke, diabetes, HIV, bowel diseases, renal disease and diseases of central nervous system.

A number of publications, study health-related quality of life in patients with heart failure. Patients with heart failure have significant impairment of all aspects of health-related quality of life, not simply physical functioning.³³ The physical (role and functioning) health burden is significantly greater than that suffered in other serious common chronic disorders, whether cardiac or other systems. Patients with heart failure that underwent a Left Ventricular Assist Device (LVAD) in situ, showed poorer health-related quality of life and psychological functioning compared to transplanted and explanted patients. A LVAD is an acceptable alternative therapy in selected patients who are not candidates for cardiac transplantation. More importantly, health-related quality of life is a predictor of mortality and morbidity after cardiac procedures. Presence of symptoms, such as chest pain, fatigue, and shortness of breath affect health-related quality of life when patients recover acute cardiac events or procedure.

Continuing, other factors that were found to be connected with poor HRQoL are symptomatic activity and the need for hospitalization in inflammatory bowel disease. Sociodemographic variables, like being female, older, less educated and divorced/widowed, are related to poor HRQoL in patients with end-stage renal disease (kidney function 5-10% of capacity). Women report lower psychological health, a more negative perception on different aspects of their environment and a stronger dissatisfaction with their finances and opportunities for recreation and acquiring new skills.⁴⁹ Finally, subjective (perceived) cognitive impairment in multiple sclerosis (MS) was found to be connected with poor HRQoL.