[amyjess]

Ultimately, I am going to quote one of my favorite writers [0] and say that I am not afraid of a life that ends.

I don't want to be a brain in a jar. Or in a computer either. I enjoy experiencing physical sensations and interacting with the world in meatspace. And if I can't enjoy either, then just let me die.

And I apply this to not just brain preservation, but any attempt to artificially prolong the quantity of my life at the expense of the quality of my life. I do not want to spend my last years in a hospital bed hooked up to machines and unable to move. That was how my dad died, and even then he was lucky enough his partner (who he had discussed this with before and who had the authority to make the decision) eventually agreed to switch him to palliative care in his final hours. Similarly, I have seen what chemotherapy does to people, and I have long since decided that if I ever get cancer, I will refuse chemo and let myself die. I am also having a living will drawn up that includes a DNR order, multiple scenarios where doctors will be ordered to pull the plug, and a prohibition against anyone amputating any of my limbs or sensory organs even if it's necessary to save my life.

I will make sure I die with my autonomy and my dignity intact.

[0] Al Ewing. He writes comics. Read his stuff, he's good.

[xnorswap]

Do you have a source for this quote? Googling just returns this page.

I was particularly struck by:

> if I ever get cancer, I will refuse chemo and let myself die

And figured this quote must be at least 20 or 30 years ago? Cancer isn't necessarily a death-sentence, and many treatments are much less harsh than they were 20+ years ago.

[latexr]

> (…) and a prohibition against anyone amputating any of my limbs or sensory organs even if it's necessary to save my life.

> I will make sure I die with my autonomy and my dignity intact.

Amputees have autonomy, dignity, and rich lives. To believe that the loss of a limb is so severe that death is preferable is absurd and insensitive.

What if instead of requiring an amputation, he loses faculties by accident like suffering from parosmia due to COVID or having a weight crush a body part? Did he suddenly lose his dignity? He certainly lost some autonomy. What’s the next step then?

[bambax]

Many people end their life when they find it's too painful to live. Many more wish they could -- the debate around end-of-life issues is raging in many countries.

[gregjor]

> To believe that the loss of a limb is so severe that death is preferable is absurd and insensitive.

No. Denigrating someone expressing their personal opinion seems absurd. Since the commenter did not impose their opinions on other people you had to put those words in their mouth to call them insensitive.

I prefer to die with autonomy and dignity as well, meaning I would like to pull my own plug. That other people might have a different threshold, or want to die differently than I might, seems neither absurd nor insensitive. The commenter just described their threshold, they didn't judge other people.

[hinkley]

I suspect part of extending human life much beyond 120 years is going to be finding ways to delay physical adulthood, so that proportionally you still have the same time to learn and grow, and those growth hormones are still kicking around repairing things for longer. Because the quality of life 100 years after your organs have stopped repairing themselves is not going to be that great, but if you could reduce that to 80-90 years then maybe.

[kelnos]

This seems a bit extreme. Chemotherapy and its effects can be a very temporary thing, and your quality of life can go back to normal after you've finished your course and the cancer has gone into remission. Certainly there are aggressive cancers where you'd be fighting a painful battle of attrition, but there are many cancers where prognoses are good, and quality of life once treatment is done is more or less the same as before. A blanket personal ban on chemo is reckless and shortsighted.

The prohibition against amputation and sensory organ removal is a bit nuts too. You'd rather die than have someone remove one of your eyes or ears, or say a hand or arm or foot or leg? That is profoundly sad, and intensely insulting to anyone who has had to deal with that sort of thing and has nonetheless lived a full, rich life.

I get that many medical interventions do actually have a terrible, permanent effect on quality of life, but these seem like pretty extreme views that ignore reality.

[gregjor]

I don't know what the commenter who posted about chemo and amputation actually thinks or believes. But I hesitate to call them "nuts" or to lecture them about how they have a wrong opinion. And I would not expand their personal opinion as a judgment on people who decide they can live with the effects of chemo, or amputation, or loss of an eye, because nothing in the original comment included a judgment on other people. Everyone has their own threshold for what they consider a life worth continuing, but we should not impose our own thresholds on other people, or judge them for making different choices.

For me the question goes beyond "Can I survive chemo (or amputation) and resume something like a normal life?" When you have to face cancer or loss of a limb or any illness or injury that threatens your life, or perceived quality of life, or dignity and autonomy, you necessarily have to think about what that means for your future. Until you get a diagnosis of (for example) cancer you don't know what it feels like, or how you will react, to the fact that no matter if you survive the treatment or not, you will always have that threat and reminder of your mortality in your conscious thoughts. You think about how you might not get so lucky the next time, how much your treatments might cost, what your illness might put your loved ones through, how far you will go to keep yourself alive even when it imposes costs and obligations on other people. And you think that maybe other people will have to make hard decisions about your future if you can't. A cancer diagnosis doesn't just affect me, in other words. If I lost a leg or arm that would impose burdens on my wife and family, affect my ability to make a living. Those thoughts more than the medical condition itself lead people to arrive at opinions such as the original commenter expressed.

Having faced my own mortality already I know I think more about how my own end of life scenarios affect other people more than how they will affect me. I worry that I will suffer a stroke, or slip into dementia, before I can pull my own plug, leaving people I care deeply about with that awful obligation, and the burden of caring for me rather than living their own life. And it's that thought, not the fear of disease or dying, that leads me to my own ideas about how much I might endure, because I won't endure it alone or without cost to others.

[paxys]

> I enjoy experiencing physical sensations and interacting with the world in meatspace. And if I can't enjoy either, then just let me die.

Who says a brain in a jar can't enjoy either of these? Who says that isn't, in fact, what you are enjoying right now?

[gregjor]

More realistic to make plans for dying, than to fantasize about living forever.

[tartoran]

Cancer is no longer a definite death sentence and chemotherapy can make it go away for good, depending on what kind of cancer that is. I'd refuse too chemo after chemo in a very aggressive form of cancer though.