The US Supreme Court has left it up to each State to make its own legislative decision on physician-assisted suicide. The ruling has attracted new attention to the issue of how medicine, the law and society meet the needs of the dying. Polls suggest that more than half the public, as well as many doctors, favor legalizing physician-assisted suicide. But opposition from religious groups and medical associations has stalled numerous State bills aimed at easing restrictions. It is widely recognized that physician-assisted suicide occurs across the United States, even though the practice is banned by statute in 35 States and criminalized by common law in nine others. This underground approach to easing the suffering of the terminally ill is likely to continue until some formal policy consensus emerges. The assisted suicide debate has caused many Americans to think about matters on which few would choose to dwell. By forming policies responsive to end-of-life concerns, society can bring comfort to the living as well as the dying.