The facts about indications and risks were explained again. He refused again. The appeal to sentimentality then ensued—think of your family, your grandkids, and how they need you alive and well. He refused. His wife, who cannot be described without resorting to the cliché “long-suffering,” pitched her case as well. Her pleading began with an appeal to reason, then shifted into an angry monologue. She told me about their many visits to different medical centers. Each time Mr. B. was told he needed dialysis. Each time he refused, and she had reached her limit. Disgusted with his stubbornness, she walked out of his room repeatedly to collect her thoughts.