I can be decisive, with reasonable certainty, because I’ve gone down this road with patients many times. Recently I operated on an 87 year old women with a huge, unremovable cancer of the pancreas. There was nothing I could do surgically to relieve the obstruction to the bile ducts that this tumor had caused. She was an intelligent woman, without any close relatives, and a couple of days after the operation I sat down with her and explained the situation.