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Whatever his reasons, they're his. If he's too scared, doesn't care, simply doesn't want to do it, if his mind is sound, it's his decision.
If you were to somehow force him to do this and there were consequences of a terminal nature or even worse a vegetative state, and it was not his wish to have had this surgery, what then? A life for you and your boyfriend of bitter regret and remorse?
Cowardice, fear, pride, what have you, is what you want the best thing for him?
We all move on eventually. Whether it's this day or the next that final day is coming no matter what we do to stall it.
Hope for the best, plan for he worst. Your god, they say, has a plan. My understanding is that he isn't much for sharing what that plan is. So, hope and pray, support him as best you can, but, well, it's his life no matter the quality or quantity remaining.
I may not be very smart, but what if I am?
Stinky says, "Women should be obscene but not heard." Stinky is one smart man.
www.humanewatch.org
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