It is a balancing act, to be sure, regarding "feeling better" vs "less sick". Hospice care is indeed very important. It can go too far in this direction, howeve

It is a balancing act, to be sure, regarding "feeling better" vs "less sick". Hospice care is indeed very important. It can go too far in this direction, however, and I have real sympathy for docs that get it "wrong" in either direction (too much "comfort" or too much "let's give you more years"). Notably: the prescription opioid epidemic is a great example of how this can go wrong in the opposite direction of healthcare providers valuing "relative" benefit vs "absolute" benefit. My spouse is a primary care provider, and there was a period a couple decades ago where the prevailing wisdom was "if a patient says they are in pain, they are in pain, and you treat that pain. We are experts in medicine, but the patient is the expert of their own perception." This is still a complicated issue today, but there are clearly outcomes where we can make people "feel better" all the way to an early grave. For the terminally ill, it seems absolutely appropriate to me to let the patient guide whether they wish to accelerate their death in exchange for quality of life. But "terminally ill" is often not such a black and white issue...we are all eventually mortal. If things like heroin don't inspire a sense of horror or dread, then we just aren't speaking the same language. I, for one, don't want to live in a world where the human priority-at-large is everyone defining "living" as maximizing pleasure until their death. For the hedonists, I get why this makes a certain nihilistic sense, but I think the horror of the reality of it outweighs any momentary benefit. In the very abstract, maybe it doesn't really matter one way or the other. In the concrete day-to-day reality of it, it's absolutely awful to see anyone struggling with any kind of addiction, out of control of their own lives...sometimes because they got on a treadmill-to-death on the _expert_ advice of someone trying to "help them out."