End-of-Life Decisions should be required reading for all clinicians. The increasing intrusions of the law, the impact of managed care, and the loss of the intimate relationship between the best of the old-style family practitioners and their patients, in addition to our ability to maintain vital functions in those who, in the past, would have died despite our best efforts, make these decisions part of the ordinary day-to-day practice of medicine. As the authors are careful to point out, there are unlikely to be any fully rational decisions in such an emotionally important area. We all—patients, families, and doctors—bring a history and multiple meanings (psychodynamics) to the decision process. However, psychodynamics are not psychopathology and do not necessarily invalidate a decision to accept or refuse treatment or supportive care or to request help in dying with dignity.