What Would You Do If You Only Had Six Months To Live?

by Sable4 min read20th May 201545 comments


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Recently, I've been pondering situations in which a person realizes, with (let's say) around 99% confidence, that they are going to die within a set period of time.

The reason for this could be a kind of cancer without any effective treatment, an injury of some kind, or a communicable disease or virus (such as Ebola). More generally, the simple fact that until Harry Potter-Evans-Verres makes the Philosopher's Stone available to us muggles, we're all going to die eventually makes this kind of consideration valuable.

Let's say that you felt ill, and decided to visit the doctor.  After the appropriate tests by the appropriate medical professionals, an old man with a kind face tells you that you have brain cancer.  It is inoperable (or the operation has less than a 1% success rate) and you are given six months to live.  This kindly old doctor adds that he is very sorry, and gives you a prescription for something to deal with the symptoms (at least for a while).

Furthermore, you understand something of probability, and so while you might hope for a miracle, you know better than to count on one.  Which means that even if there exists a .0001% chance you'll live for another 50 years, you have to act as though you're only going to live another six months.

What should you do?

The first answer I thought of was, "go skydiving," which is a cheeky shorthand for trying to enjoy your own life as much as you can until you die.  Upon reflection, however, that seems like an awfully hedonistic answer, doesn't it?  Given this philosophy, you should gorge yourself on donuts, spend your life's savings on expensive cars and prostitutes, and die with a smile on your face.

Something doesn't seem quite right about this approach.  For one, it completely ignores things like trying to take care of the people close to you that you're leaving behind, but even if you're a friendless orphan it doesn't make sense to live like that.  Dopamine is not happiness, and feeling alive isn't necessarily what life is about.  I took a university course centered around Aristotle's Nichomachean Ethics, and one of the examples we used to distinguish a "happy" life from a "well-spent" life was that of the math professor who spends her days counting blades of grass.  While counting those blades of grass might make her happiest, she is still wasting her life and potential.  Likewise, the person who spends their short remaining months in self-indulgent indolence is wasting a chance to do something - what, I'm not quite sure, but still something worthwhile.

The second answer I thought of seems to be the reasonable one - spend your six months preparing yourself and your loved ones for your inevitable demise.  There are things to get in order, funeral arrangements to make, a will to update, and then there's making sure your dependents are taken care of financially.  You never thought dying involved so much paperwork!  Also, you might consider making peace with whatever beliefs you have about the world (religious or not), and trying to accept the end so you can enjoy what time you have left.

This seems to be the technically correct answer to me - the kind of answer that is consistent with a responsible, considerate individual faced with such a situation.  However, much like the ten commandments, the kind of morality that this approach shows seems to be a bare-minimum morality.  The kind of morality expressed by "Thou Shalt Not Kill," rather than the kind of over-and-above morality expressed by "Thou Shalt Ensure No One Shall Ever Die Again, Ever" which seems to be popular on LessWrong and in the Effective Altruism community.  Or at the very least, seems to be expressed by Mr. Yudkowsky.

So I started wondering - what exactly would someone who judges morality by expected utility and who subscribes to an over-and-above approach do with the knowledge that they were going to die?

There's an old George Carlin joke about death:

But you can entertain and the only reason I suggest you can something to do with the way you die is a little known...and less understood portion of death called..."The Two Minute Warning." Obviously, many of you do not know about it, but just as in football, two minutes before you die, there is an audible warning: "Two minutes, get your **** together" and the only reason we don't know about it is 'cause the only people who hear it...die! And they don't have a chance to explain, you know. I don't think we'd listen anyway.

But there is a two minute warning and I say use those two minutes. Entertain. Uplift. Do something. Give a two minute speech. Everyone has a two minute speech in them. Something you know, something you love. Your vacation, man...two minutes. Really do it well. Lots of feeling, lots of spirit and build- wax eloquent for the first time. Reach a peak. With about five seconds left, tell them, "If this is not the truth, may God strike me dead!' THOOM! From then on, you command much more attention.

As usual with Mr. Carlin's humor, there is a very interesting idea hidden in the humor.  Here, the idea is this: There is power in knowing when you will die.  Note that this isn't just having nothing left to lose - because people who have nothing left to lose often still have their lives.

My third idea, attempting to synthesize all of this, has to do with self-immolation.  The idea of setting yourself on fire as an act of political protest.  Please note that I am not recommending that anyone do this (cough, any lawyers listening, cough).

It's just that martyrdom is so much more palatable a concept when you know you're going to die anyway.  Instead of waiting for the cancer to kill you, why shouldn't you sell your life for something more valuable?  I'm not saying don't make arrangements for your death, because you should, but if you can use your death to galvanize people to action, shouldn't you?  In Christopher Nolan's Batman Begins, the deaths of Thomas and Martha Wayne were the catalyst that caused Gotham to rejuvenate itself from the brink of economic collapse.  If your death could serve a similar purpose, and you are committed to making the world a better place...

And maybe you don't have to actually commit suicide by criminal (or cop, or fire, etc...) but the risk-reward calculation for any extremely ethical but extremely dangerous activity has changed.  You could volunteer to fight Ebola in Africa, knowing that if you catch it, you'll only be dying a few months ahead of schedule.  You could try to videotape the atrocities committed by some extremist group and post it on the internet.  And so on.

In summary, it seems to me that people don't tend to think about dying as an act, as something you do, instead of as something that happens to you.  It's a lot like breathing: generally involuntary, but you still have a say in exactly when it happens.  I'm not saying that everyone should martyr themselves for whichever cause they believe in.  But if you happen to be told that you're already dying...from the standpoint of expected utility, becoming a martyr makes a lot more sense.  Which isn't exactly intuitive, but it's what I've come up with.

Now pretend that the kindly old doctor has shuffled into the room, blinking as he shuffles a few papers.  "I'm very sorry," he says, "But you've only got about 70 years to live..."

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44 comments, sorted by Highlighting new comments since Today at 1:17 AM
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It seems like most of the replies here are ignoring the fact that the actual point of the article is its last paragraph.

(Or maybe I'm wrong in thinking that's the actual point. Or maybe those replies are going along with the article's suggestion that we can get insight into the question in the last paragraph by considering the 6-month version.)

Maybe you can get some insight that way, but of course there are important differences. If I really had only 6 months to live, I'd stop working and dieting right now and go buy some beer. If I still had 70 years to live, I'd want go back to school and learn another profession.

All utilitarian calculations, to my knowledge, have to start with an examination of one's goals. If your primary goal is to enjoy life (nothing wrong with that), then that approach is fine. If your goal is to help the world, then I'm arguing there are things you can do in your six months that others can't or won't because the behaviors are too dangerous.

Maybe there are, but I bet they don't involve translating boring business software. So if I heard that diagnosis today, the first thing I'd do (after telling my husband) is email my customers I'm retiring for health reasons, then I'd go out to buy some of that nice, strong beer I've not been not drinking lately because I want to lose weight, and then I'd start thinking about what to do next.

But maybe I should start thinking about it now. Realistically, I expect to die of cancer sometime between 20 and 30 years from now, based on my family history. When I'm an 80-90-year-old woman with cancer, what will I be able to do? Can't be anything physically demanding, because I'll be sick and in pain... Well, with any luck, I have 20 years to think of something.

I think that the point is that if you have a little time left, you can use high-risk opportunities that you wouldn't otherwise use. As for the last paragraph, I don't think it conveys a very important message. Should you be more or less risk-averse? Maybe yes, maybe no -- it depends on how risk-averse you are now. There are people who miss important opportunities with quite small risks, and there are people who put themselves in danger without sufficient reason. For me, risk tolerance is a continuous function of estimated time left. Risks that I would take if I had 6 months are quite different from risks I would take if I had 70 years, and those are different from risks I would take if I had 700 years; and it's fine and correct.

I think you've mostly got it right, although I didn't do the best job of communicating it. At first I was just pondering the idea that utilitarianism seems to support martyrdom if you're going to die anyway, but I realized that the theory actually applies to any finite lifespan. If we lived forever, the marginal utility of our lives would theoretically increase ad infinitum - we could bring more and more learning and experience to each problem we face.

However, until that happy day when nobody has to die anymore, thinking of death as an act (something you can use) instead of an act of god (something you take out insurance for) might help altruistic causes. This also might be a good attitude for soldiers to take (or one they already take, but not being a soldier, I wouldn't know).

It also, I think, helps me as a person to think of dying as something I do - it makes me feel more in control of my life, rather than just living with a scythe over my head that may come falling down at any moment.

I will probably write a book based on my life now because yesterday April 27, 2019 at 9:47pm my doctor told me that I only have one year left to life. I don’t know what to do but that’s ok because I don’t think any 14 year old would know what to do if they were told they only had one year left to live.

[-][anonymous]6y 6

Write a book for my child, basically trying to put all my wisdom / experience into it. My father passed away a year ago and it still bothers me we have not discussed anything serious in the last 10 or so years. I need his brain, his experience, it is far too hard to deal with life without his advice, and yet all I have is photos. We really owe it to our children to write down everything we could teach them.

I would write a book anyway, even if I had no child, the best service I can give to the world is helping others figure out certain things quicker than I did.

Apparently, retiring professors traditionally give a lecture entitled, "The Last Lecture," during which they talk about what wisdom they want to leave behind. This particular book is the lecture Randy Pausch gave after being diagnosed with terminal cancer.

My father-in-law has literally only ~6 months left. He did write books with his life wisdom. These were intended for his children to preserve and pass on his knowledge. These are part biography part message and a trove of insight into his life. But I didn't get much general insight from that and I'm unsure whether it helps his daughter in her life-decisions. One early book is called 'living as a warrior' and a late one 'some lint from my shroud'. Some ideas appear to me obscure. Some trite. And the context is missing (both sides: a) to understand what he means and b) how he'd apply that to our situations).

I'm considering this. I'm accumulating an Anki-Deck of 'essential real-life insights'. But I'm not sure about the right way to 'teach' this. These concepts are so much condensed and they can't be taught easily. The inferential gap is too large. Currently it is more a reminder for me to build up toward that and to use ideas from that in everyday interaction. Explaining things I do with (strictly unneccessarily) precise terminology that will be needed later. I considered a book. But more an orbis pictus kind with multiple layers of meaning. But that is just too hard to do in parallel.

[-][anonymous]6y 1

Sure. However the goal is not merely to help, although that is a big part of it. The goal would be to leave something better behind than photos. Something as close to a "mind upload" or "mind simulation" as possible. To enable my child to have something like a discussion with me after I am gone.

For example, one of my most "radical feeling" and unusual feeling ideas is that learning some martial arts is essential to developing masculine qualities, and developing some qualities is essential to well-being as a straight man at least, because fighting is one of the basic animal experiences like feeding, sex, or social life and should not be missed out. I mean, it is essential for probably everybody, but for a straight man it is even tied to sexual selection, so doubly so... My dad was kind of telling me similar things when I was 15 but I brushed them off I said "I am an intellectual, I live in my mind, I have no need for this body-oriented animalistic things, don't try to turn me into some baboon". Then I figured it around 35. So it would be pretty cool now to have this quasi-conversation with him, a chapter in a book, describing how he figured this out and what the experiences were like. It would be simply better than just having photos, a mind dump, a mind download onto paper. I don' thave Anki cards in mind, rather the opposite, a biographical narrative that tells how was what figured out through what life experiences.

And even doubling as a historical account. Have you read The World Of Yesterday from Stefan Zweig? Too bad he died childless, as it is awesome to read such perceptive subjective histories even if you care not for the person who wrote it, imagine how cool it would be if you really were close to the author!

My dad was kind of telling me similar things when I was 15 but I brushed them off I said "I am an intellectual, [...] Then I figured it around 35.

But then he did tell/teach you. And all the context and real life experience was necessary. It wouldn't help to just read it.

[-][anonymous]6y 1

Sure but at 35 I could now read it and see his bio how he interpreted it and how he figured it out and how used it.

I will not experience any effects of whatever changes I work upon the world using my death, nor what happens to my loved ones should I die without my affairs in order. Après moi, le dèluge.

Insofar as it's possible, I try to actually enact the "sorry, but you've only got about 70 years to live" thing, but with a time horizon twenty times longer, that looks a lot more like a normal life than it does like the "go skydiving" option for when you've got a six-month diagnosis.

Well, obviously step 1 is look for a cure. But I think the answer is absolutely "live life as normal, but with a personal time horizon of 6 months." If I have 70 years to live, that's plenty of time to slowly learn a field of work and do some interesting stuff. If I have 6 months, I can work on maybe one idea. My time is probably much better spent on evangelism and just having a good time - if the expected value of my work goes down and the value of time spent having fun is fixed, I should have more fun.

[-][anonymous]6y 2

Aha. It sounds like working for love, not a paycheck. I would instantly quit my job as it the opposite case. That would be actually one of the upsides of it. Sometimes the dream of never seeing the inside of an office again feels like it would worth a high price... although not as high as that. But 5 out of 7 days wasted on office fuckery to make someone else rich and achieve pretty much nothing is else actually another kind of a short lifespan - maybe long in the gross, but short in the net, living only 2/7 of it.

If I could start over, it is possible I would choose a "fun" major instead of a "safe" one AND not start a family before I have a "fun" (or "meaningful", "world-changing") job.

Or maybe not. I have the impression that enjoyable jobs are for neurotypicals because they involve things like networking to get a job. With "safe majors" one can just apply to job advertisements on monster.com this is why I chose it, so that I never have to eat lunch with people I don't personally want to (which, to be fair, is almost nobody, with rare exceptions).

That would be actually one of the upsides of it.

You could anonymously hire an assassin to kill you in exactly six months. Then you could finally live free! (Not a serious advice.)

Also, you might enjoy reading this book. (Somewhat related, also this one.)

Also, you might enjoy reading [Veronica Decides to Die].

You might also experience intense annoyance, though, as I did.

I think one of the points I didn't quite manage to make is that, in this situation, there isn't really a cure (and you can't find one in six months). I'm reminded of Bean from Ender's Shadow, who finds out that he's only going to live to about 20. The medical team researching him wishes that he could help, genius that he is, but Bean was taught warfare, not biology.

You raise a good point, though, that if you are really good at something, you should probably keep doing it - much like Bean helps Peter Wiggin wage his war.

Realistically I'd probably wrap up my affairs and prepare my loved ones, but broadly I think the comparative advantage is in performing high-risk services. The first thought that came to mind is volunteering for useful dangerous experiments that need live human subjects, but there's probably a lot of bureaucratic barriers there.

I wonder if there are any legally feasible high risk and helpful services that also pay really well...

If you're looking for high-risk activities that pay well, why are you limiting yourself to legal options?

I'm not limiting myself to " high-risk activities that pay well", I'm limiting myself to "legally feasible high risk and helpful services that also pay really well" ;)

The "helpful" is the goal, the rest are instrumental. I think most stuff leading to morally good outcomes is legal. Even illegal stuff which might be good if only it were legal turns out bad simply due to the practical realities of illegal operations.

Out of curiosity, can you name any such activities? The first thing I thought of was donating your organs (whichever ones were healthy enough to donate). Especially if you could arrange to have them all taken at once when you die, and then put the money into a college fund for your kids or whatever.

To be honest, if I'd know one of my parent's kidneys had gone into paying for my chemistry class, I probably would have attended more.

For "high paying" I guess it depends on how much your earning potential at your current job is. Off the top of my head, there's a few dangerous but very high-paying blue collar jobs - Crab fisherman, oil rig worker, and the like. Working with carcinogens and radiation is also a go, as mentioned elsewhere, though I'm not sure about compensation there. For "social good", Terminally ill patients are at least eligible to volunteer to test drugs for their particular illness.

I'm still in the "spend time with your loved ones and help them come to terms with it" camp though.

I'd probably make sure my friends and family were prepared over the first month, and after that point, depending on the progress (are your chances of resurrection better if it happens while you're alive?) sign up for cryostasis. Preferably offing myself before the cancer progresses too far to maximize my chances; assuming that would not affect my chances, I'd probably live as I'm used to. I don't enjoy excitement, and though it would be sad to die so soon, I think I would be happier with my quiet life as it is.

I realize I'm kind of dodging the hypothetical here, but that's legitimately what I would do. I don't have big, overarching goals in my life beyond to live simply and long. Given the latter's out of the question at this point in time, I may as well maximize the chances of such in the future.

Given that you discarded the first answer on the basis of "feeling alive isn't necessarily what life is about", shouldn't you apply the same criterion to the second answer as well? I am pretty sure that keeping your paperwork in order isn't what life is about.

The third answer is interesting, but you're still subject to the Law of Unintended Consequences, so if you are planning on making a large impact, make sure you understand all the consequences of this impact...

Yeah, paperwork isn't what life is about.

Caring for and supporting the people who you love and who love you, on the other hand, is a large part of what life is about. At least for most people.

Caring for and supporting the people who you love and who love you, on the other hand, is a large part of what life is about.

True, but that isn't changed by your life expectancy.

Now pretend that the kindly old doctor has shuffled into the room, blinking as he shuffles a few papers. "I'm very sorry," he says, "But you've only got about 70 years to live..."

I don't think these are comparable. In particular, the person with six months to live has something the person with seventy lacks: A comparative advantage over the rest of the population with respect to risk. That is, risky actions cost them less.

So my answer to "six months" is: Do things that were "off your list" only because they involved greater personal risk than you were willing to accept. That applies whether you prefer a life of hedonism, utilitarianism, or a mix of both. Go skydiving and also assassinate Hitler (for arbitrary values of Hitler). But your preference for hedonism-vs-helping-the-world shouldn't necessarily change.

Given this philosophy, you should gorge yourself on donuts, spend your life's savings on expensive cars and prostitutes, and die with a smile on your face.

"Donuts. Cars. Prostitutes. A Jedi craves not these things."

The thing to do is to manage your remaining time as best you can in support of whatever your values are. Well, that came out a bit dry. I suppose "live life to the fullest" is another way of putting it, except that it is generally taken as recommending frivolous hedonism.

If currently your life is one of irksome toil to build a better future life, then you might as well take the better life now, if your current accumulation of money will cover its brief remainder.

If your current life is one of donuts, cars, and prostitutes, in the expectation of assuming a more sober life later, you might move in the opposite direction.

If your life consists of the work that you want to happen for its own sake, without longing for the day when you can set down the burden, then a shorter life will only have implications for how to best support that work with the remainder.

If you're already leading a life of frivolous hedonism and see no reason not to continue, you're probably not reading LessWrong.

ETA: I know how long the company I have my pension arrangements with expects me to live. It's not 6 months, but it's not 70 years either.

That's "expects" in the statistical sense: the mean of a distribution, which says nothing about its shape.

If you're already leading a life of frivolous hedonism and see no reason not to continue, you're probably not reading LessWrong.

Counter-example here! ;)

If I had six months to live, I'd take my life savings and sign myself up for cryonics. ;)

I would act as though he were wrong, for anthropic reasons. In other words, six months later (or 70 years later) I will certainly not wake up one day and notice that I am dead, since this can never happen to anyone.

But six months (or 70 years) minus one day later, you might wake up and notice that you are dying. That can happen very easily.

Yes, of course, but people sometimes recover after they are dying, and even after they are dying, they don't find out they are dead the next day.

Would this brand of anthropics imply that you never actually die in experiential terms? Given processes of bodily degradation, etc; this brand of immortality might be equivalent to a personal hell were it to exist.

Human value is complex. I'd guess that the resonable approach would be 'all of the above'. I seem to remember the recommendation 'live life to the fullest'. Sure prepare and tell your relatives - but only paperwork? Why not also have some high-risk fun?

[-][anonymous]6y -1

If you can predict the future, couldn't you have told me sooner?