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Writer's pictureMargaret Cutler

End-of-Life Decision-Making

We usually assume that all people want to live a long and healthy life. Well, one fascinating client showed me that this is not necessarily the case. She came to see me because she was dying of metastasised cancer and her family were suggesting everything they could to help her get better.


As she came into my office she said: “Before we do anything I am letting you know that I do not want any therapy at all. My sister drove me here and she is waiting outside so if we could just talk for about half an hour, I will then pay you and leave.


I will then not come back. This will keep my sister happy that I have come to see you, I will be happy that I have had no therapy and you will be paid for your time.” WOW!! To say I was surprised would be an understatement.


Naturally I wanted to know her story and why she was pretending to get help and then refusing it without even giving it a chance.

She told me her story.

“I owned a restaurant that was going very well until I made some stupid decisions. It was my own fault. I wanted to do things my way and would not listen to anything anyone said.

My business went downhill and eventually I declared bankruptcy. I was totally to blame.


Had I not been greedy and just did what was working I would have kept the business, had a good lifestyle and been free to enjoy the things I like.


After the business was closed down I developed cancer and I knew that it was because of the bad business decisions I had made and the humiliation I felt wherein I had lost all sense of self -worth.


But what has been wonderful is all the sympathy I am getting …all my friends ring me every week to see how I am going and I feel loved and valued.


I know that if I get well they will forget the cancer and I will be just another business failure and I can’t handle that. I do not want people to think badly of me – so I will die and they will remember me with sympathy and kindness!”

End-of-Life Decision


Nothing I said could dissuade her from this path she was on and so she happily passed away a few months later.


I wonder what would have happened had she allowed me to work with her? I surmise that at the bottom of her problem was a deep lack of self worth which was why she was needing the sympathy of her friends and family so much rather than her life.


If we could have worked together to rebuild her sense of personal value and her self esteem then she would have let go of the shame she felt over her business decisions and to see them as a learning. She might have gone on to having a wonderful life surrounded by her friends and family.


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