Pressure both from families and overwhelmed healthcare systems is a reality. Given the burdens of care imposed on families when a loved one is seriously ill, access to a legal option to avoid a long period of debility and need for costly personal care has undeniable appeal- but not necessarily to the patient. In one instance I was contacted by email by the wife of a patient with recurrent glioblastoma to discuss his care options. Because of his mobility difficulties, I visited them at home. It quickly became clear that the purpose of the visit was to see if I would help to hasten his death. When I began to explore what had precipitated this request and asked what the patient feared about the future, he looked at his wife and did not answer- his wife did. I explained the benefits of palliative care in terms of symptom relief and support for both patient and the family throughout the remainder of his life- the patient was interested and asked several questions about what home care options were available and about what the process of dying was actually like. I described it. He seemed reassured. His wife however, appeared more and more irritated, saying 'we know all about hospice and we are not interested.' When I asked to speak with him individually, she thanked me for coming and escorted me to the door. Had aid in dying been legal in NY at the time, I have no doubt that she would have found a willing prescriber and helped her husband – who had months to years to live- to hasten his death. When family members are stressed and burdened by the role, when the illness is bankrupting the family, the patient gets the message."