THE MANAGEMENT of patients with fatal illness, especially in the late stages of their lives, has become the subject of much concern in the past decade. Multiple articles have appeared in health related, as well as in general publications, concerned with different facets of the dying experience. Descriptive words such as loneliness, isolation, and despair are now in common parlance, as are such psychological terms as denial, bargaining, and acceptance. Institutional medicine’s concerns have grown as more people die in hospitals and nursing homes. For people with long term chronic and fatal illness, the hospital is not just the place where they die, but is the major support system during the last months to years of life. The after effects of a death on survivors have also been receiving considerable attention. Death may come suddenly and unexpectedly, or after a prolonged and chronic illness, resulting in different bereavement patterns in survivors. Such patterns are influenced by age, direct kinship relationship, personality characteristics of survivors, and other psychologic and socioeconomic factors. In a broad sense, a death and consequent bereavement exposes survivors to potential deterioration of mental, social and physical health [l-3]. Increased mortality due to heart disease, suicide, and other disorders have been noted, as have serious depressive states and psychosis, and such derangements as alcoholism, extensive drug use, and inappropriate behaviors [4-61. Work and school problems as well as increase in anti-social actions, have been recorded [7, 81. Visible grieving is scarcely acceptable today as a social requisite, and an exhibition of grieving beyond the initial days after a death is given little tolerance by middle class American society. Most bereaved, after an intense week or so of open community and family support, are usually left on their own, with proscriptions against ‘carrying on too long’. The intra-psychic and interpersonal problems in bereavement behavior are poorly understood by most health professionals, although some excellent reviews of grief and bereavement exist in medical literature [9, lo]. In general, medical support systems for the bereaved do not exist in our communities. The clinical course for many cancer patients, and for their families, is marked by