The Last Refreshing Taste

To the Editor.  —As Dr Bone continues his confrontation with mortality and metastatic renal cancer, his touching and eloquent writings^1,2 incite us to provide compassionate and irreproachable care to severely ill and dying patients. Unfortunately, care of terminally ill people is a neglected aspect of medical care,¹ despite the fact that most physicians come in close proximity to death during daily encounters with patients. To compound the neglect, the locale of the deathbed scene has migrated from a homebound environment to an institutional setting, with death frequently occurring alone and without family, friends,³ or physician in attendance, particularly in long-term care facilities. Regrettably, absence or withdrawal of a physician from terminal care negatively alters the physician-patient relationship during its final and vulnerable phase, and fosters familial discontent and an image of patient abandonment. However, such detachment may reflect a universal fear of death and an identification with