In Reply I appreciate the thoughtful response by Nothelle and Finucane to our Research Letter regarding states worse than death in hospitalized patients with serious illnesses.1
As we mentioned in our Research Letter1 and Nothelle and Finucane highlight in their response, people have difficulty forecasting how they would react in hypothetical situations and frequently adapt to previously unimaginable states of debility and dependence that accompany aging or illness. For this and many other reasons, the data presented in our Research Letter1 should not be taken literally to mean that a significant number of patients would actually choose to die rather than go on living if they were, for example, to become incontinent.
Rubin EB. States Worse Than Death—Reply. JAMA Intern Med. 2017;177(4):593-594. doi:10.1001/jamainternmed.2016.9666