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.

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.

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 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.

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.

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

You have to remember that from the self's perspective, being dead is not an alternative to being alive. Being dead is the end where no alternatives exist. You are not choosing between life and death. You are choosing between immediate death or the continuation of experiences, followed by death.