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Comment by teiferer | Hacker News Reader

Agreeing with your overall sentiment, but this caught my eye:

> If I'm 80, I'm (somewhat) less concerned with length of life, and more concerned with quality. If I'm 50 that's a different equation

Why is that? Is quality less important at 50? Would you be more willing to endure suffering if you are younger? Why? I'm thinking that no matter age, people would generally like to avoid a painful death. Maybe it's because it feels more likely to "beat this thing" when you are younger, and then still potentially have decades ahead of you?

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> Why is that?

By 80 most people have reconciled with the idea that they don't have too many years left even in the best of conditions. There's no hope of extending life, and there's little to look forward to, they already lived through all the important milestones they could realistically see. Quality is all that's left to hope for.

At 50 they still can still hope for recovery and a life beyond that. They have a lot of moments and milestones ahead of them, at least with family and loved ones - see their kids graduate, get married, or have their own children. So if the hope is stronger than the pain, they'll sacrifice the quality of life.

> By 80 most people have […] already lived through all the important milestones they could realistically see.

That’s at least partially culturally determined. As the healthy live expectancy creeps up slowly, I expect that idea to change. There’s some truth in the saying “50 is the new 40”

This doesn’t really make a difference in the argument. You can sub 80 with 90 and the point remains the same. There is some age where you stop caring about trying to be cured, and just care about the quality of life in the immediate future

It makes, if cultural expectations lag reality of longer life spans.

I think it does; society thinks 80-year olds are physically less fit than they are in reality, shaping expectations of what 80-year olds should want, and I also think 80-year olds are influenced (even if slightly) by that.

> society thinks 80-year olds are physically less fit than they are in reality

If anything the bias is the other way around. You get to see all the 80 year olds who are fit enough to interact with society. You never see the the ones who are wasting away in their homes, hospices, and hospitals. Being old and needy is an invisibility cloak.

> I also think 80-year olds are influenced (even if slightly) by that

That "slightly" is doing a lot of heavy lifting. At that age people care about society only in the "decent human being" kind of way, not in the "let me please some strangers" kind.

> If anything the bias is the other way around. You get to see all the 80 year olds who are fit enough to interact with society. You never see the the ones who are wasting away in their homes, hospices, and hospitals

That’s true, but I still think there’s societal pressure on acting old for the elderly.

As a tiny example, if you’re in your 20’s friends and family ask “how’s your job hunt going?”. In your 40’s, they ask “how’s work?”. In your 60s they ask “are you still working?”, even if you’re fit as a fiddle, and even though pension age creeps towards 70 in many countries.

The expectation, basically, is that you work till your mid sixties, enjoy retirement for ten years or so, grow old, and die.

That’s statistically true, but there are outliers. I think that expectation makes some of the outliers at the healthy end reach that final stage slightly earlier than needed.

My parents are in their eighties and they still have a good quality of life and things to look forward to.

They do have some health issues but they aren’t decrepit.

That's good to hear but that wasn't really the topic of the conversation. We were discussing people with life threatening illness where the treatment severely lowers quality of life for a very uncertain outcome.

Do you think the "things to look forward to" would incentivize your parents to focus on clinging to life at the expense of drastically increased suffering and plummeting quality of life, or on maximizing the quality they still have at the expense of losing some months or years?

Even if you are still in good condition overall, at that age you know you're probably running your last lap and the things to look forward to are nowhere near as satisfying as they were even a few decades earlier. You can always find joy in the little things but they're always shadowed by other inevitabilities.

Many healthy years to you and your family.

I was responding to "there's little to look forward to, they already lived through all the important milestones they could realistically see .." which seems to imply that by 80 life is over and not worth living.

> which seems to imply that by 80 life is over and not worth living.

That's a big leap you made. But I'll tell you what, this is a question you'll be able to answer when you are in your 80s, not your parents. I have a strong feeling you'll understand what I mean without needing to jump to conclusions.

I think you've got it exactly right:

- what is the expected gain? Years+Quality

- what is the maximum gain? Years+Quality

The older you are the smaller your maximum gain of Years can be.

What if you have young kids? It might be worth the suffering for their benefit.

Perhaps don't have kids in your 40s. It's pretty mean to have kids at 50 because of the high risk of sickness or death while they're teenagers (or younger). Plus the risks of genetic faults in children rises dramatically for dads or mums much over about 40. After 40 kids will often miss out on having grandparents.

Our society says parents can make whatever choices they like, but having children is one of those places when we should be thinking of others (the kids) not ourselves.

I decided against having kids when I reached 40ish for the above reasons (along with some other reasons).

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