JANE QUIGLEY is 84 years old. Since childhood she has suffered from asthma. During her adulthood (from age 20 to 65) she smoked about 2 packs of cigarettes per day. At age 70 her breathing became more troublesome and she began seeing a pulmonologist. When she turned 78 she went to another pulmonologist who told her that she had emphysema and that she would have to be tethered to an oxygen tank if she wanted to be comfortable. She was outraged at learning about her condition for the first time and angry with her previous physician for not telling her what was wrong with her. But she bravely got the oxygen tank and still retained a decent level of mobility. At this time she appointed a friend (she had no family) to be her Durable Power of Attorney for healthcare. When the attorney-in-fact attempted to discuss her end-of-life wishes with her, she refused to engage in the discussion saying only "I have appointed you to take care of this and I trust you to do so." For the next three years her quality of life was fairly decent. Then she took a turn for the worse. Her breathing became much more labored and she remained home-bound for most of the time. She was in and out of the hospital frequently. She never had to be put on a respirator but she needed a good deal of respiratory therapy. Shortly after her 84^th birthday she was diagnosed with lung cancer of a particularly aggressive sort. By the time the tumor was discovered it was already the size of a baseball. The prognosis was that she might live for 3 months. The diagnosis was made on one of her visits to the hospital but her doctor refused to make her a DNR or even discuss the matter with her. Her attorney-in-fact arranged for a hospice consultation but before that could occur, her physician rejected the idea of hospice care. Instead the physician persuaded her to go to an extended care facility from which she would be transported three times per week to the hospital for radiation therapy. When she was admitted to the ECF her attorney-in-fact presented her advance directive to the admissions clerk as required by the Patient Self-Determination Act. Jane was furious that there would be discussion about her advance directive while she was so sick. Radiation treatments continued for a month until she died.