Quality Versus Quantity of Life: Beyond the Dichotomy.

A restrictive and dichotomous question has become the primary approach in many goals of care discussions. Is the primary goal of care of life through aggressive therapy or of life through comfort care and hospice? Even though many health care providers recognize that quality vs quantity of life (QvQ) is a false dichotomy, in practice QvQ underlies many goals of care discussions and can negatively impact patient care. This article offers strategies for assessing patients at the end of life, presenting a first-line conversation process that can support a range of treatment options as well as a diversity of dynamic patient values.