Finally randomized into this card after getting it from repackaged TFA Investigator Expansion. I still take draw action as required and play draw cards like Stand Together as normal to see how it plays out.
The excitement of the deck thinning down but not yet hit the card is great, as some scenarios offer a way to Resign and I have to think more than usual how could I resign a round or two before others, yet the remaining investigators can still finish the job. I also can take AoO to kill myself on my favorable side of health / horror to avoid drawing it, if the deck is down to < 10 cards.
I only start thinking of tech-ing the weakness this way if the scenario is nearing the end (e.g. Completed all objectives, just some extra VP remaining), otherwise the team would be inefficient because I'm too selfish about avoiding the weakness.
I am also fine with bringing new investigators in mid-campaign, it make deckbuilding idea and investigator choice quite different. You can choose someone with starting XP, someone with 5 stat ready for basic work, deck with some testless damage / clue, or coming in with cards specifically to support those that are still alive and don't require any test, like Contraband, "I'll see you in hell!", Dodge, Thermos, Obsidian Bracelet, True Grit, Old Book of Lore, Scrying, Premonition, Teamwork, ... This investigator's deck likely be an unpublishable, party-specific deck, or even "tech" the campaign's quirk. I would not get to build a deck like this starting the campaign at the first scenario. It's time to go wild.
Having The Bell Tolls in the deck in the final scenario can be quite a bummer, as if I hit it early I would became just a ghost-coach / doom token manager in that final scenario watching my friends play with no next investigator to come in. But I understand the impact wouldn't be there if the kill is not immediate, and tension will be unmatched if I seemingly not getting it halfway through the final scenario. There is also still some sense of strategy of trying to leave as much legacy for the team as I can before I dies, so they can continue to finish the campaign. One thing I did is to pass on resources and items with Teamwork earlier than usual as it give away control and they won't get removed when the owner is eliminated.
The upgrade process placing the new version "live" on the bottom of deck is, at first, I think is unnecessarily harsh. I thought they might not want the final scenario to be free if you are not yet at The Bell Tolls. It would still have the same effect if the upgraded version is placed in the discard pile and get shuffled after deck reset. But I finally understand that this design is actually kinda cool! I was at Scenario 7 with 2nd Accursed Fate and didn't think this would be my final scenario, after all I know there is one more step. However I got it when deck is very thin and The Bell Tolls coming in and you can see it is clearly there is quite spooky and... strategic! I count actions I am required to run to Resign, AoO I am required to take to kill myself before drawing that final card, or how many ammo could I unload my gun or locations I could help reveal before I go. I think this struggle is a unique experience for what mostly is a "you randomly dies" weakness. For twice a campaign its location is not random...