I am an oncologist, and Dr. Lynn’s comments are absolutely correct. But there is much “overlap” between her 3 examples, unfortunately, another unexpected consequence of our more successful cancer treatments that buy a bit more time for people with advanced cancer. Some of the cruelest dilemmas for patients, families and for me are when one of my patients with cancer that is for the moment, under control (but will ultimately come back) gets some other medical problem — heart failure, kidney disease etc. that can be “treated” successfully. They then survive to go on to die of their cancer anyway. In one respect, these episodes represent lost opportunities for a simpler death. I often talk to patients about choosing between somewhat easier (untreated pneumonia, “the friend of the elderly” or forgoing dialysis in renal failure) and really hard ways (painful, wasting death from cancer or the suffocating death of end-stage congestive heart failure) to die. It seems to me that the truly courageous people are at ease with letting go sooner (and religious beliefs don’t play much of a role.) Few people can think rationally about the use of resources (or potential waste of resources) when it comes down to an individual’s life–their own, or their loved one’s. So many decisions about the end of life seem to be driven by the fear that one’s life has not yet been lived…so the lesson I try to take away for myself is to live now.