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Death in the late 20th and early 21 centuries has been made a medical issue. It occurs more often than not in an atmosphere of ongoing attempts at treatment, neglecting overwhelming evidence of futility that should be evident to patient, families and especially medical attendants. Unwilling for a number of reasons to face reality, physicians carry our entire culture along in their conviction that determination and science can achieve miracles. The result has been a marked increase in end-of-life suffering, disappointment, and cost. That cost has been not only in dollars, but in the spiritual and family considerations that should be part of the end of a life. These matters will be discussed, as will proposals for a solution.