To the Editor.
— The article by the SUPPORT investigators1 is an outstanding and comprehensive study of the US medical system's treatment of dying patients. Unfortunately, the data the authors present are a terrible indictment of physicians and our medical system. This study clearly demonstrates the failure of the US medical system to deal rationally and humanely with dying patients and provides evidence of the enormous medical and financial resources consumed by futile medical care.The SUPPORT project sought to understand and to improve medical treatment of dying patients by facilitating communication between physicians, patients, and families. This is a logical first step in reducing patient suffering and unwanted prolongation of life by heroic measures. However, the study's failure to improve care or alter outcome for dying patients shows that more powerful forces exist in our health care system that drive futile care. Large monetary rewards are available to