As an internist practicing geriatrics, there were many dilemmas that had to be handled as patients approached end of life. As the speaker dealt with these issues for 17 years, she developed a program to teach medical students, residents and practicing physicians about frequently encountered issues. This presentation includes ethical approaches to such issues as withholding vs. withdrawing medical interventions, medical futility and advance directives. Continued interest in these topics has led to presentations to estate planning attorneys and to the lay public in a variety of venues.