Hmm, perhaps I am still too vague in my assertion. Let me try again.

It is not the outcome that I am drawing a comparison on, it is the activity.

In Napoleonic and even American Civil War era medical practice, there were a lot of prospective patients that flatly refused treatment even in the face of probable death without it rather than succumb to the conventional remedies of the time, such as amputation of an injured limb to better control profuse bleeding and/or risk of infection.

Could we imagine going through open-heart surgery without anesthesia? Who would be willing to endure such an experience fully conscious and able to feel every slice and tug? At the time you are about to go through such an event, would you consider refusing the procedure? Would you be able to even lay there unrestrained and let them do what they need to do to you?

Yes, intent is a fundamental difference, but has absolutely nothing to do with the experience of the recipient. Without the anesthesia, there is no physical difference in the sensation, the fear, or the physical trauma inflicted, other than the surgeon will have a more aesthetically acceptable technique.

If faced with a choice of going through such an experience and dying, or not going through such an experience and dying, what is the sane conclusion? Twould be consterning for one in their youth/prime to face such a dilemma, not so much for one who feels they have already lived a full and satisfying life.

A quote I often cite: "Everybody gotta die sometime, Red."