Commentary: balancing life and death--proceed with caution.

Hospital professionals' decisions to permit death are amalgams of medical, ethical, and legal judgments. Medical education and socialization and the business of health all focus on offering and providing treatment, not on facilitating death. Some patients are suspicious that rights to refuse care will foster abandonment by care providers. Lawyers and risk managers often let exaggerated fears of future liability limit patients' and families' rights. The culture of medical institutions must change to accommodate notions of negotiated death.