Quality of life is a subjective concept, yet there have been some real and constructive attempts to measure the quality of a person's life so that meaningful comparisons can be made during treatment and as disease progresses. In this paper the multifaceted nature of quality of life is explored and the ways that the communication of healthcare professionals with a patient can dramatically influence the patient's sense of personal dignity and worth. Inherent in this are the relationships with the family, particularly with children in the family, who may suffer greatly in bereavement. Pressures on patients may make them feel a burden, as if they would be better off dead and certainly as if others may be better off without them still alive. This sense of being a burden is often behind requests for death hastening acts such as euthanasia. The fundamental difference between euthanasia and the cessation of futile treatments is also explored. The pivotal role of good communication is the route to ensuring that issues are addressed, with hope maintained for the patient to live as well as possible until they die, and that patients' quality of life is maximized.