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Doctors are obligated to help patients in ways likely to make a difference in their quality of life – controlling pain, improving mood, addressing sleeplessness, etc. – and should offer chemotherapy only as a last resort for those who still want it after true informed consent as to the unlikelihood of it doing any good, doctors need to emphasize they will not abandon the patient with end-stage disease, and that there are ways to help that are not ‘ active treatment, ’.