Editor—In the last paragraph of their article Thompson et al highlight the fact that the hypothetical advance directive makes no reference to the quality of life.1 The reciprocal nature of the quality of life is seldom considered, usually only an individual perspective is taken. Western society has focused increasingly and now almost exclusively on the individual with regard to gratification and now to life itself.
Monsignor Ronald Knox précised Bishop Berkeley's 18th century philosophy with the following limerick.2
There was a young man who said “God I find it exceedingly odd that this very tree Should continue to be When there is no one about in the quad” Answer “Young man your question is odd. I am always about in the quad. And that's why this tree Continues to be” Signed by, yours faithfully, God.
If one takes a humanist perspective, the individual can be represented by the tree having significance or quality by virtue of another's presence in the “quad.”
Competing interests: None declared.
References
- 1.Thompson T, Barbour R, Schwartz L. Adherence to advance directives in critical care decision making: vignette study. BMJ 2003;327: 1011-4. (1 November.) [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Andrews R, Biggs M, Siedel M. The Columbia world of quotations. New York: Columbia University Press, 1996.