Implicit in the right of patients to consent to their own medical care is their right to refuse medical care, even if this results in their death. Patients’ right to die preoccupies bioethicists. The authors believe this is a misplaced concern: with the exception of a small number of well-publicized cases such as that of Nancy Cruzan, current reimbursement policies shift the concern from right to die to right to live. These cases mask the everyday ethical conflicts between MCOs, which make their profits by reducing care, and every patient needing expensive care that is not immediately curative.