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I want to start by talking about a patient that I had.

Her name is Anne.

We'll call her Anne.

Anne is 74 years old and presents to the emergency room with aspiration, pneumonia, and septic shock.

She has congestive heart failure, diabetes type 2, chronic obstructive pulmonary disease,

pulmonary caeccia, hypertension, and a history of stroke,

sepsis, and respiratory failure. She had a G2 placed about six months ago due to ongoing malnutrition.

Since that time, she has been in and out of the hospital with increasing frequency for serious

bacterial infections. She has difficulty clearing secretions and great difficulty blocking.

I actually want to just keep this case in mind for now. We're going to come back to it a little later.

So to begin with the studies, this is probably the briefest summary of studies you've ever seen,

but here I'm just drawing from a number of different studies about judging quality of life.

And essentially, the studies show that sometimes from the outside, we correctly judge a patient's

quality of life.

That is, we judge it as the patient

would, him or herself. And sometimes the studies show that we don't correctly judge the patient's

quality of life. Just to give one particular example, studies do consistently show with respect to

persons with disabilities in particular that from the

outside, we underestimate the quality of life of persons with disabilities.

One thing that's interesting, though, is that other studies show that persons with disabilities

...