Confusion, misunderstanding, and ethical concerns may interfere with patients' choices for appropriate treatment and subsequent quality of life. Such concerns did not originate from recent technological advances but from the ancient Greeks and Romans who honored health more than life, and the early Christians who honored life more than health. These opposing concepts reflect differing notions of quality of life. Determining the quality of life involves personal issues--the cognitive ability to evaluate one's own life; the perception of a satisfactory state of social, emotional, physical, and mental health; and an acceptable feeling of well-being despite physical limitations. In contrast, and often conflict, are objective evaluations of treatment outcomes, morbidity/mortality statistics, cost/benefit analyses, and age studies performed in an attempt to determine quality of life by persons other than the patient.

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