To the Editor: I read with great interest the recent Clinical Case Conference by Joan Wheelis, M.D., about her psychotherapy with a borderline patient and the subsequent discussion by John G. Gunderson, M.D. (1). However, after nine pages of detailed text, I was struck by the one-paragraph dismissal of Ms. A’s decision to terminate treatment when her mother became ill with leukemia. This sudden and seemingly premature termination of the discussion seemed to mirror an abrupt termination of therapy. The impending mortality of the mother and Ms. A’s termination of her relationship with her therapist seem to annihilate this fragile patient’s only support system. In a teaching article like this, I believe such circumstances warrant a detailed discussion of how a therapist should handle a patient’s impending loss, a patient’s desire to terminate therapy prematurely, and most important, an assessment and treatment of dangerousness in such circumstances with a borderline patient.