Beyond Quality or Quantity of Life

Ariel Dempsey is funded by a Rotary Scholarship from District 6290 in Michigan in the USA for 2021-22 and 2022-23 to study for a DPhil in Science and Religion at the University of Oxford.




Ariel Dempsey is a recently graduated medical doctor going into palliative care and doing her DPhil at Oxford in Science and Religion at Oxford. Emerging from clinical experience and her studies of theology were some serious concerns about the language used with patients in conversations about their goals of care. Together with her physician mentor she has written an article, “Beyond Quality or Quantity of Life” and is in the process of submitting for publication.

Abstract of the article Beyond Quality or Quantity of Life

Conversations with physicians, colleagues and patients make it clear that a dichotomous way of thinking about quality versus quantity of life (QvQ) underlies many goals of care discussions and impacts patient care. This QvQ framework is epitomized by the question, “Do you want our goal of care to be quality or quantity of life?” which is too restrictive for the complex realities of medical care. Based on decades of experience in palliative care, we suggest several open-ended questions to serve as values “vital signs” monitoring dynamic notions of quality of life: 1.) What do you understand about your disease? 2.) What is your understanding of the plan? 3.) What is important to you? 4.) Are the plans currently in place helping you to achieve what is important to you, or standing in the way of your goals? We wrote this article because we saw an opportunity to move beyond this dichotomy of QvQ to Values-Treatments Harmony, a more inclusive and expansive way of thinking, responsive to individual patients and their values.

Ariel Dempsey, MD and John Mulder, MD