Euthanasia is widely debated in the medical literature and lay press in terms of morals, anecdotes & medical or legal ethics. This paper approaches the issue from a patient-centred perspective, giving four case histories to demonstrate widely varied motives or hidden agendas for requesting euthanasia. It concludes with guidelines in an approach to communication which may empower the caregiver when confronted with a patient requesting assisted death or suicide. (6 refs.)