David Meager and David Balk stated that “the role(s) played by the dying person in the family can affect the decision-making process family. For example, the patient has played the role of peacekeeper or scapegoat within the family, his imminent departure will have the effect of stabilizing relations between the other members of the family because there is no longer anyone available to help him manage or take responsibility for the conflict. David Meager and David Balk stated that the current consensus that "the patient has the right to refuse medical treatment, even if it hastens his death, has led to controversy over whether the morally accepted view that “nature takes its own course” (i.e. passive euthanasia) can and/or should be extended to allow a terminally ill patient to direct the course of their nature (i.e. say active euthanasia or physician-assisted suicide The question is whether there is a moral distinction between intentionally allowing a disease process to cause death or intentionally causing death through the use of additional (usually pharmaceutical) means. ) to stop the disease Health care providers, bioethicists and families are divided on answering these questions 'the painful decision (even if it was the choice of death) not to treat the symptoms because. the disease could not be treated, was a thin line