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Comment by vamos_davai | Hacker News Reader

It's such an absurd expense that I wonder if I get diagnosed with cancer, I would just deny treatment, accept death, and hand my assets to loved ones. Not sure if anyone else thinks the same way.

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That is rational thinking through and through. Part of the reason that medical costs are so high is because some people will pay any price, to themselves or to society, to get/stay healthy.

A rational person says "some costs are too extreme and thus we must allow some to die".

A flip side of the argument is that very high cost(read profit margin) of treatment incentivizes others to fund research for treatments and cures.

I don't think anyone can think about it realistically until they are in that situation. How much is another year of your life worth to you? And to your loved ones for that matter? (assuming we're talking terminal cancer here, which it might not be)

I have family that suffered from cancer and spent a good lot of money prolonging their life by about eighteen months. They were not pleasant months, but I don't think for a second that the family would have preferred to take the lump sum instead.

In short, every decision is horrible.

My mom fought cancer at great expense and with everyone's support, and just ended up prolonging her suffering. When my dad was diagnosed with cancer a few years later, remembering that experience, he fought pretty much everyone and declined treatment, and died swiftly. If my turn comes and my odds are about as bad as theirs, I may well prefer to follow his example.

I'm on the downward side of 50. My best years (physically) are in the past. My kids are nearly adults. I'd rather pass on my assets to them and set them up for a better life than piss it away on medical treatments that don't have much hope of working.

My point is that your kids might not agree with you, and it is difficult, to say the least, to negotiate that situation. I'm not saying you're wrong, just that everyone has a different answer.

Take that lump sum or in another way of looking at it have that lump sum taken from them. Depending on the family situation this could cause knock on effect leading to financial burdens that who knows, could lead to suicide? Is that worth 18 months of a doomed persons life?

They wouldn't have the lump sum taken from them if they consented to it. And many do, sometimes with more enthusiasm than the person technically giving the money.

A lot of cancers have good a prognosis, especially if diagnosed early. Would you still do so if your chance of long-term survival and full remission, with treatment, is 50% or higher?

Problem is, the treatment provider offers no hard guarantees: full remission or your money back. The claimed success rates could be based on research studies, which have a reputation to be systemically flawed.

> Over a 10-year stretch, he said, Amgen’s scientists had tried to replicate the findings of 53 “landmark” studies in cancer biology. Just six of them came up with positive results.

https://slate.com/technology/2016/04/biomedicine-facing-a-wo...

I think it depends on cost. Maybe if the cost is 5x my yearly income, then it's probably not worth it for me to continue going on.

I'm not even in US and I'm considering the same.. if the expenses go above some reasonable threshold, I don't see the point of me living enough to see my family dragged into poverty. I don't delude myself - it's not easy to do.

Part of the problem is that, especially with an illness with as complicated a treatment process as many cancers, there's no way to even estimate the expenses. Even once you get treatment, the expenses might not be accessible until the bill comes in and you find out what your insurance company will pay for.

After that, there's a sunk cost issue: once you've dropped (N*your current net worth) on treatment, what's the harm in continuing?

That was actually one of the cornerstones of the HSA for everyone plan that Ben Carson was pushing. The government would pay into your HSA and when you got a diagnosis like that, you’d have the option of not continuing treatment and passing the balance of the HSA to your family.

I think your family would spend that money and more to get more time with you.

Still not rational. Just because people want to do something, does not mean it is the best decision for them.

How much time? Two weeks? This is how long some of these advanced, very expensive, cancer meds give you. https://www.bmj.com/content/357/bmj.j2097

I think that route is unpopular because we no longer have a sane relationship with death as a society. Religion, at least in theory, should help, but rates are declining there too. We'll pay any price to avoid the inevitable. We'll spend hundreds of thousands to get one more year of poor quality time with family, yet neglect to spend that time in better quality when health is taken for granted.

If you had no family, you could save many more lives for cheaper and easier to treat sicknesses, plus donating your healthy organs.

This is precisely my plan. I gave away upwards of $1 million USD last year. I have no assets remaining, no career, parents, spouse or pet. I’m almost out of money finally.

40 something white American male college drop out with no social connections. Tinnitus and hyperacusis long term.

The biggest part is figuring out how to maximize the donation of my organs to the medical school by coordinating self termination in a country where suicide is still largely frowned upon.

I have no insurance and just yesterday I had serious chest pains for the first time on the right half. This is almost certainly the result of not taking care of my body. Better to self terminate and spare suffering and resources, and to donate the organs.

As it turns out, there is no way to donate most organs unless you pass in an appropriate medical setting, to keep the organs alive.

The next best option seems to donate body to medical school.

When societies began moving on, philosophically, from dogmatic religions and into the current era of empiricism, we lost the ability to put death in context. Empiricism tells us that when you die, there is nothing, and the objectively rational thing to do is whatever it takes to live as long as possible. Empirical thought patterns tend towards extremes. What society needs to do, and possibly is in the process of doing, is recognizing empiricism as an incomplete model of reality. Hopefully that will lead us back towards a healthier relationship with our mortality.

If you've got kids and a family, they may not agree. It's a terrible situation to be in.

So it's definitely something that goes through your mind, however I've had the discussion with my wife. There's also the possibility that you'd be cured. It's entirely going to depend on your diagnosis, which you literally don't know until after you've gone through a CT scan, PET scan, and possibly surgery to determine tumor staging. I can say based on numerous conversations with other people, if you think you're going to die, you're going to die. Cancer is also extremely painful physically for some people with or without treatment. Best bet? Get life insurance.

I have two friends who have survived cancer. Both of them have said that they would skip treatment if they could relive the experience. I lost another friend to an agonizing one year battle with glioblastoma.

If I ever receive a cancer diagnosis it will probably be the end of me. I have great life insurance and my survivors will be well taken care of. Even with the modern, immune-based chemo(which my friend had for melanoma), there are severe and permanent side-effects. After watching my friend with GBM die, I realized the medical industry is more than happy to take any money you have even if there is no chance they can help.

I would consider this seriously for myself.

I've been thinking about my own death since ~2003. I have established what I want to happen to my body; I have yet to determine an official will, medical attorney, &c and that great fault is on me.

I recommend following "Order Of The Good Death" for the "US alternatives on Death". It is good times. Yes, talking about Death counts as "good times"; it is not difficult to imagine your survivors arguing over your body... about your body... about your assets... about your legacy... about your estate... and so forth.

This is a very good reason to make sure one has a living will.

My doctor and I had a conversation about this and that was his position, though not for reasons of expense. He says it's a fairly popular position amongst his peers, as well. Those who get to see first-hand what treatment looks like don't want to go through it themselves.

That's any easy statement to make when being diagnosed with cancer is some small probability potential future event.

Not that I really disagree with the sentiment, but I find it difficult to judge people actually staring death in the face based on my comfortable position of, well, not.

I always thought this was the way to go. People routinely punch the numbers to figure out if they can 'afford' to have a child, why is it so strange to do the same for end of life?

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