While it may only be the third-leading neoplasm worldwide, lung cancer is the first cause of death by cancer in males and one of the first in females in industrialised countries. Overall, cure rate is only 10–15% and the majority of patients, most of whom are diagnosed at an advanced stage and will ultimately die from lung cancer progression or related complications. During the last few decades, palliative care has become a central element of the therapeutic approach to terminally ill cancer patients. Palliative care aims to improve quality of life and control symptoms but has no role in hastening death, although palliative care specialists can be involved in the end-of-life decision process when euthanasia or physician-assisted suicide are considered. The opinions of the cancer patient and their family, the treating physician, or both regarding their preferences in end-of-life decisions have been assessed in general studies not including a specific cancer type. Outside of religious or sociocultural particularities, suffering from pain or fatigue is a prominent factor associated with euthanasia requests and practice in cancer patients [1, 2]. Requests for euthanasia or assisted suicide are reported with higher frequency in poor-prognosis cancers, such as lung, pancreas, stomach, oesophagus, lip–mouth–throat or melanomas, in comparison with those having better life expectancy, such as as prostate or haematological tumours [3]. In this issue of the European Respiratory Journal , Pardon et al. [4] report the first study specifically dealing with euthanasia requests and practice in lung cancer patients. This prospective study was based on questionnaires sent to pulmonologists, oncologists and general practitioners immediately after the death of their patient. Among 115 deaths occurring during an 18-month period, 105 questionnaires were returned by the physicians, replies from specialists (91%) being more common than from general practitioners …