Having faced the situation described in “Questions Concerning the Goodness of Hastening Death” (May 2006: 312–314) the very weekend I read the article, I had a vehement reaction to it. The author seemed to assume that patients, families, and health-care providers function at a level of ignorance that can be overcome only by research and advanced degrees. True, many people are unable to talk about death before they’re confronted with a life-threatening illness. But many patients and their families incorporate religious beliefs, cultural mores, knowledge about their disease process, and personal values into decisions about how death should be approached.

As a patient advocate I strive to develop relationships with patients and their families that will make me privy to the process by which decision making occurs, without imposing my own beliefs. As I have become more experienced at the bedside, I have rethought calling certain actions “withdrawing care” and...

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