This article notes that while suicide driven by desparation must be prevented when possible, responsibilities to those seeking to escape unreleivable suffering is less clear. Requests to stop life-sustaining therapy can be rationalized but some patients have no treatment to stop. Stories of intolerable suffering by incurably ill patients who have no escape other than death & potential physician responses are explored. 7 clinical criteria to guide physician-assisted dying are proposed. (19 refs.)