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Have you ever been in a situation like you describe? I think human instinct kicks in. I've been in situations I thought I would rather be dead than in - but when in them you tend to want to fight even if the odds are against you. It takes a true belief there is no hope to actually want to die rather than fight.

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I've been in those situations. Your description here does not match my experiences at all.

I _hate_ the vernacular of "fighting cancer". As a leukemia survivor, it wasn't a fight. You don't punch back. It's more akin to public flogging. My body was absolutely destroyed by the treatments, and as I watched myself turn from a human being to a not-yet-dead skeleton, I had to endure people calling me "brave" and a "fighter". It absolutely felt like public mocking (though the people around me certainly did not intend anything of the sort). I was forced to watch my loved ones struggle with my impending death. Only a couple people were able to actually discuss death with me, with everyone else dancing around the topic like I had nothing more than a bad sunburn.

I never lost hope, but I was expecting to die. The "fight" worldview kept my loved ones emotionally distant and distracted. Maybe that was good for their own mental health, but it certainly didn't help mine.

I'm sorry you had to go through that. Do you have any ideas on a better framework for society to approach this? As you allude, people intend the best for the patient, and this seems to be what we've come up with. "You are a fighter, you can do this."

It seems like the two possible frameworks are fighting vs enduring? (Others?)

If I had to guess, we might choose to position the patient as a fighter because to fight against harsh odds requires courage, so what we're giving is the compliment that you are courageous. I think that's the intent at least.

I think the "fighter" rhetoric is specific to individualistic cultures that place a high premium on personal agency. Westerners in general and (liberal, college-educated) Americans in particular have a really hard time dealing with the idea that something might be largely or wholly out of their control. The opposite extreme would be fatalistic cultures, where one's death or survival is in the hands of god - deo volente, besiyata dishmaya, inshallah.

I think a reasonable middle ground starts with acknowledging that being seriously ill is just a shitty situation, that over a long enough time frame death is inevitable, and that outcomes are often determined mostly by dumb luck. Not being in control can be very distressing, but the struggle to try and retain control often just compounds that distress. Willing someone to "fight" a cellular process within their body probably isn't going to help them in any meaningful way, but there are lots of things that can be done to make them more comfortable. Hope is valuable, but false hope is a kind of cruelty; we all need to be better at accepting the limits of medicine and recognising the threshold of futility.

Fantastic point - basically it'd be great to know how much it matters that the patient "fights". I do disagree that, "Willing someone to "fight" a cellular process within their body probably isn't going to help them..." in that we have some evidence that the mind can affect the body a fair bit, everything from the effectiveness of placebos to control of autonomic states. Who knows if one could rally better cellular defenses by feeling aggressive and active. One would be much more likely to stave off depression, which is caused by helplessness, especially if one doesn't have a higher power concept in their life that they could accept is in control.

> especially if one doesn't have a higher power concept in their life

I don't think believing in metaphysical beings provides any protection against depression. Espcially if you're facing problems you can't solve (i.e. helpless), and your chosen being doesn't come up with the goods. And "in the middle of cancer treatment" would be a bad time to lose your religion.

Sorry for your experience. It was a bad choice of words. By 'fight' I simply meant choose to do everything possible to stay alive (even if that means simply enduring horrendous medical treatment despite the pain that comes with that) rather than deciding it's not worth it and choosing to die.

It also comes to mind that it is relatively uncommon in the human experience for things to just continuously get worse before they get worse. Most people have experienced things eventually getting better, teaching them perseverance and faith.

Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.” They mean it.

https://www.zocalopublicsquare.org/2011/11/30/how-doctors-di...

> Have you ever been in a situation like you describe?

Knowing that death is certain? Yup. In fact I never expected to live as long as I've lived.

> I think human instinct kicks in.

Well, there's some kind of motive, sure; but "human instinct" implies that all humans have it built-in. I'm a counter-example, and I'm not alone in that.

> It takes a true belief there is no hope to actually want to die rather than fight.

Oh, I don't want to die. I'd struggle, e.g. if I was faced with a murder; might as well have a go. But I wouldn't struggle like the folk in TFA to get access to unlicensed experimental cancer treatments.

I didn't read the first article, so I don't have the full context. It makes a huge difference if you have people counting on you. It makes sense to struggle for the sake of other people.

[Edit] Arguably, participating in a trial is struggling for the sake of other people; but that's not the attitude I got from TFA.

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