[notjosh]

As a cancer survivor, I feel so conflicted about this. On one hand, I can completely understand where you're coming from. But on the other hand, I think seeing things in such black and white terms is pretty shortsighted. When there's a terminal prognosis, many/most doctors will offer an array of treatments and therapies to help manage symptoms without trying to make you feel worse. There are several middle-grounds that can help extend life without prolonging it (a fairly semantic, but very important difference).

Which, of course, leads to my next major gripe: end of life treatments (even outside of cancer) are generally awful. Euthanasia and assisted suicide laws are sorely lacking. Palliative care systems tend to stretch people's last days out so thin, it's awful.

So, despite refusing treatment, you may still end up in palliative care in undignified and grim circumstances. That's a tragedy. We need to do better.

[crag]

//As a cancer survivor, I feel so conflicted about this.

I don't. I'm one of those that survived AIDS (had cancer (KS), CMV, etc - in other words - the whole bad of horrors).

I got lucky, good timing, I held out long enough. But many didn't. And I saw what hanging on does to people. It's stunning to see a guy who 6 months ago weighed 210lbs of muscle and now he was [trying] standing before me; 110lbs who couldn't spend more then 10 mins out of the toilet.

I think, ending your own life on your own terms is possibly the bravest thing you can do. It's not easy to take your own life.

For years, I had a special stash of drugs in a place I could get to even if I lost my eye sight (I almost did). And I set a limit - if my eyes went I would go. I never understood why our society expects people to fight the good fight. You should be able to make that decision yourself.

Right now, you have to beg for help, or go into hospice and wait it out. Usually very high on morphine and barely able to get out of bed. Awful.

You are right, end of life care is terrible in the US. Just terrible. We need to start teaching people that death is nothing to fear. And sometimes, it's a better choice.

[alanwatts]

>I never understood why our society expects people to fight the good fight.

One reason I would guess is the massive fortune that is made off pharmaceutical sales.

If someone takes their life early, that is potentially hundreds of thousands of dollars saved by the family that otherwise would have went to big pharma.

[crag]

Nahh... that's probably part of it. But in many cases, it's the family insisting that you "drag it out".

I remember at NY Hospital, this guy (in the next room) was VERY sick (AIDS) - he was at end of life. Had 105+ fever they could not get down. He was laying on a bed of ice, and the nurse was pouring ice water over him - all at the insistence of his sister.

I remember thinking how could she torture her brother so much? I know she loved him. And it was a vain attempt too save his life. He wasn't conscious though most of it, but I think he would've preferred to die in peace and quiet rather then laying on a bed of ice.

He lasted till the morning. What a way to go.

That's why Living Wills and Medical Directives are so important.

[alanwatts]

Indeed, pharma sales are maybe only a small part of the reason.

The biggest reason may be the irrational terror certain societies have regarding death, which is something easily exploited by terrorists.

Even many of those who claim to know they are going to Heaven when they die are terrified to do so, indicating they don't really believe.

But where does the root of this terror come from? Perhaps it is the false belief of an artificial separation between mankind and nature

[percept]

There was an article recently agreeing with this point--that a mix of fear, selfishness, and guilt imposed by family and friends motivates many to "keep fighting," when they had previously and privately (away from loved ones) expressed their wish to die.

IIRC, the doctor in the article discussed how awful she felt at witnessing and being part of these prolonged treatments.

Can't find it now, but this seems to be a topic with a long history on NYT:

https://www.google.com/#q=site:nytimes.com+doctor+prolong+li...

Also:

http://opinionator.blogs.nytimes.com/2014/09/06/when-its-the...

[buro9]

I remember reading this:

http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die...

It moved me greatly, and also resonated because shortly after a friend of mine at the time, a cyclist with a wonderful personality and charisma, was diagnosed with a stomach cancer and within two weeks, on New Year's Eve, he died.

I remember him in hospital, he knew what was coming, had taken his last ride, had refused chemo, and was now in bed dying. I remember vividly how he comforted another friend who was crying, he was in bed, in pain, and told the other friend it would be alright. How the pain wasn't so bad now, and how he would be riding soon (when he knew full well he wouldn't and the pain was causing him to wince).

It occurred to me how much he, in those last days, did more to calm and comfort the people around him, how he took so little from them.

And it occurred to me how much joy he had in those last few rides, the sun on his skin as he glided around country lanes just South of London.

It reinforced what I'd read about how Doctors die. Reinforced my personal view that life is more than a number of days. Just as work is more than a salary alone.

My wife knows of this opinion and choice, she's very strongly communicated the same opinion, and even the manner and form of her funeral.

We choose to go when the time has come, and to live life fully until that moment. Some things we would live with, but other things, with a terminal prognosis, we would embrace as the striking of the final hour. Instead of spending that hour attempting to lengthen it, we choose to live and savour every moment of it.

[hkmurakami]

>There are several middle-grounds that can help extend life without prolonging it.

This is a beautiful choice of words that sent a chill down my spine just now.

Thanks for taking the time to pick out these particular words.