There are obviously exceptional cases - diabetes immediately comes to mind - where it's a "do or die" decision, but those are the minority. Even so, it's your choice, not a doctor's.
There are standard cases that any rational person would see taking the medication as a win. The most prescribed class of medication in the article is antihypertensized. Thiazides are a frontline intervention for hypertension. Thiazide's reduction in all-cause mortality is clinically significant(HR approx: 0.51).
> The risk of primary outcome events[all-cause mortality] was significantly lower in patients taking thiazides (model 1: HR 0.51 [95% CI, 0.36–0.72]; P=0.0002; model 2: HR 0.56 [95% CI, 0.38–0.83]; P=0.004; [1]
There are of course downsides to taking any medication or medical intervention, but a HR 0.51 in mortality is such a large reduction that the risks would need to be equally significant.
I'm not sure why diabetes should get any special treatment other than there is simply more public awareness of the risks of untreated diabetes. Are the HR reduction in all-cause mortality with insulin treatments above a particular threshold of importance? Does diabetes the primary cause of mortality in more patients than hypertension? Some other factor? Happy to hear some of the reasoning behind it.
1. Thiazide Use and Decreased Risk of Heart Failure in Nondiabetic Patients Receiving Intensive Blood Pressure Treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340223/
If I unplug my insulin pump, I will feel very sick after 24 hours and probably go to a coma from ketoacidosis after a few days.
Additionally, most people would seem to account for several inputs, HR for all-cause mortality seems like a pretty good indication, but you've chosen to reject it. Any reason?
The rate of diabetes is exploding.
>37.3 million people, or 11.3% of the U.S. population, have diabetes. An estimated 28.7 million people – had diagnosed diabetes. Approximately 8.6 million people have diabetes but have not yet been diagnosed.
Oh, and what about high blood pressure.
>About 70% of Americans will have high blood pressure in their lifetimes. What's more, only 1 in 4 patients with hypertension have their blood pressure under control. And because high blood pressure usually has no symptoms, you can have it without knowing it.
Why does this matter?
>About 697,000 people die of heart disease in the United States every year–that's 1 in every 5 deaths.
I was one of them.
I eliminated processed sweets and lower my carbs and presto, from ~145 to 115 blood pressure in a few months.
"If you don't stick to your values when they're being tested, they're not values: they're hobbies." -- Jon Stewart
In this context, deciding for oneself instead of blindly accepting what one is told they should do.
i simply hope for them to make their own choices. If that choice means following a doctor's advice, that's fine. (Admittedly, 9 times out of 10 or more, that's what i'll do - the doctor is the subject-matter expert.)
Anecdote: as a recovered throat cancer patient, if a doctor were to tell me that the cancer is back and i had to undergo Treatment X or die, i'd start getting my affairs in order. In the 17 years since my cancer treatment, the only side-effects i still live with are side-effects of the _treatment_, not the cancer. e.g. i haven't slept a full night of 8 hours uninterrupted in 17 years because of side-effects of the radiation treatments, not the disease, and i'm unwilling to undergo further quality-of-life degradation caused by medical treatments. If it comes down to that, i'd choose my dignity and quality-of-(what remains of my)-life over a longer life suffering yet more side effects.
Granted, not all would make such a choice, but i inherited stubbornness from both of my parents and got a double dose of it genetically, so i don't expect to represent a majority opinion.
The point of society isnt to enforce your will on others.
At best it is a means to an end, and hotly debated how much you should be able to force compliance from others for your own benefit.
And eg most doctors will laugh at you if you said that T2 diabetes can be put into remission with diet: but it can for at least 50% of people. And the other 50% will at least drasticly lower their need for medication.
Also notice the word "remission": they can't admit that you actually healed T2 diabetes, so they use the word remission to gaslight you into thinking that "you didn't even heal it, you're just lucky and it's gonna come back".
Hard to take any doctor seriously nowadays.
So you cannot say "you're in remission" if you're eating poison.
You were poisoning yourself. So obviously if you poison yourself again you're gonna go out of "remission".
If I eat something allergenic, start experiencing a reaction, then later cut the offending food out of my diet, it doesn't mean I am in remission from my allergy; it means I am avoiding the cause of an allergic reaction.