Exploring the “near-suicide” phenomenon using mindsponge theory

Thuy Nguyen, Phuong-Minh Nguyen

Hanoi, March 25, 2023

Several years ago, scientist Vuong Quan Hoang found that patients in poor health
conditions in Hanoi were left with only two options, both of which all resulted in bad
outcomes. Based on the subjective reasoning, the patient chose between draining family
financial resources in the hope of being successfully treated, and discontinuing medical
care and awaiting inevitable death. The latter behavior pattern bears some similarity to
suicide due to its catastrophic impacts on the patient's health, possibly leading to death, so
it is called the “near-suicide phenomenon” “Why do patients opt out of treatment? Are
they not terrified of death?” the scientist kept pondering over these questions.
For the past nine years, Dr. Vuong and his associates have been actively seeking answers,
evidenced by numerous of their scientific works have been published on the subject.
However, until the work “Near-Suicide Phenomenon: An Investigation into the
Psychology of Patients with Serious Illnesses Withdrawing from Treatment” [1] has
been published, Dr. Vuong’s lasting question has been addressed to a certain extent. The
article was published in the International Journal of Environmental Research and Public
Health – a prestigious scientific journal that can be accessed via the DOI website:
https://doi.org/10.3390/ijerph20065173.

Figure 1. Probabilities of recovery or continuation of therapy in various situations of

sickness severity and financial load. Source: [1]
This study employed a dataset of 1042 patients randomly selected from a number of
hospitals in Vietnam's Northern area. The survey was carried out in 20 months from 2014
to 2015, divided into 3 surveying phases. The novelty/uniqueness of the study is the
adoption of the Bayesian Mindsponge Framework (BMF) [2,3] in the analysis of the
severity of the illness, the financial situation, and the extent to which these factors influence
the final decision about the patient's course of treatment. Furthermore, while one’s value
systems can change over time, biological structures and functions make the thinking or
reasoning mechanism of the human minds remain relatively unchanged. Therefore, this
mindsponge reasoning-designed study rules out the possibility of the dataset being old or
irrelevant with the passing time. The seriousness of the patients’ disease and their family
financial status are selected as factors influencing their decisions. Research results confirm
that the greater severity, the higher likelihood of patients quitting treatment because a
serious illness is synonymous with a lower possibility of surviving without treatment and
higher treatment cost. Moreover, their perception that paying medical fees may affect the
financial well-being of their families drives them to opt out of treatment even more.
Specifically, only 25% surveyed patients with both serious medical conditions and the
heavy burden of medical costs eventually decide to continue treatment. Based on the
subjective cost-benefit analysis, the remaining 75% tended to choose the financial status
and future of their family members over their own sufferings and imminent death.
Mankind is entering a new age, characterized by extraordinary changes, challenges, and
uncertainties. Problems such as “financial burden” [4] and “medical equipment shortage”
[5] seemed to be only seen in poor countries before, yet are now increasingly emerging in
rich countries. In fact, during the recent COVID-19 pandemic, patients around the world
had to face a severe lack of breathing masks, even refusing to take medical treatments due
to financial shortages.
Because of its broad humanistic meaning concerning human life, the current study
endeavor may have gone beyond the limits of an ordinary scientific publication. The work's
ideology opens up a study avenue for numerous themes related to various socio-cultural
contexts for the scientific community. In practice, the study provides a solid scientific
foundation for the association between "patient survival chance" and "financial burden."
According to statistics from patient surveys and the Vietnamese health care system, out-
of-town patients and impoverished households are around 70% more likely to encounter
financial difficulty during their medical treatment (excluding those who take out no health
insurance policies) [6]. The authors propose that legislators implement and alter policies in
place (for example, health insurance) to ease financial burden for healthcare services and
reduce the risk of patients foregoing treatment owing to financial constraints.
The study also demonstrates that the mindsponge theory [7] and the Bayesian Mindsponge
Framework (BMF) analysis are robust frameworks for generating and analyzing public
health data, which allows for further in-depth investigation of other severe psychosocial
phenomena.

References
[1] Vuong, Quan-Hoang, et al. (2023). Near-Suicide Phenomenon: An Investigation into
the Psychology of Patients with Serious Illnesses Withdrawing from Treatment. In
International Journal of Environmental Research and Public Health (Vol. 20, Issue
6). https://doi.org/10.3390/ijerph20065173
[2] Nguyen, M. H., & Le, T. T. (2021). Bayesian Mindsponge Framework. Scholarly
Community Encyclopedia, Mcmc, 3–6. https://encyclopedia.pub/13852
[3] Vuong, Q. H. (2016). Medical expenses matter most for the poor: evidence from a
Vietnamese medical survey. Materia Socio-Medica, 28(6), 429.
[4] Prime, H., Wade, M., & Browne, D. T. (2020). Risk and resilience in family well-
being during the COVID-19 pandemic. In American Psychologist (Vol. 75, pp. 631–
643). American Psychological Association. https://doi.org/10.1037/amp0000660
[5] Finkenstadt, Joseph, D., Handfield, R., & Guinto, P. (2020). Why the U.S. Still Has a
Severe Shortage of Medical Supplies. Harvard Business Review.
https://hbr.org/2020/09/why-the-u-s-still-has-a-severe-shortage-of-medical-supplies
[6] Vuong, Q. H. (2015). Be rich or don’t be sick: estimating Vietnamese patients’ risk
of falling into destitution. SpringerPlus, 4(1), 1–31.
[7] Vuong, Q.-H. (2023). Mindsponge theory. De Gruyter.