Susan Sontag’s death was difficult: difficult for her because she fought it to a bitter end in a treatment regime that inflicted considerable physical and mental suffering on her, and difficult, too, for her son, David Rieff, as he testified in a sober and affecting memoir of his mother’s death. By Rieff’s account, he was agonized by his inability or his refusal (he was never sure how to characterize his failure) to tell his mother the truth about his own evaluation of her grim prognosis, the utter futility of her desperate medical treatments at the end, and the burdens inflicted by those treatments on her and on him. Rieff’s distressing chronicle raises questions about the adequacy of the usual, dyadic model of decision-making, which is focused narrowly on individual physicians and individual patients, the physicians cloaked in the trappings of scientific expertise and the patients armed with their rights. This essay will explore the claims of others to participate in this decision—the claims of family members, as suggested by Rieff’s account of his participation; and then the claims of third-party strangers to the patient and her physicians, such as government agencies or professional associations.