I think a lot of people are getting the med but not taking it just so they have an "exit' if things get too bad. I would think that the notion of being trapped by your disease -- you have no control, no way to get on top of what's going on, and you're at the mercy of others who determine how much pain/sedation you deserve -- would be horrific with a terminal diagnosis. Maybe if people feel like they have the option of suicide, they feel more control, and it actually prevents people from "accidentally" overdosing on their meds like my step grandpa did. My step grandpa had emphysema, and thinking about it now, I'm betting he also had lung ca. He saved up his valium and pain meds, and took them all. Unfortunately, all he did was put himself into a coma, experience hypoxic brain damage, and he spent the last 3 weeks of his life in a hospital wailing and screaming when he could get enough breath to do so. I was 9, and it horrified me -- he'd scream, and try to get out of bed and hide -- he seemed to be caught in nightmares of his experiences during the Battle of the Bulge. Had he had the option, he might not have felt the urge to take the pills, he might have been okay with the notion that he could take them and 'escape' if he needed to. The doc was nice about it for my grandma's sake, and said it was an accidental overdose. Nobody "accidently" takes 50 pills...we knew what he'd done, but his sisters never knew.