Why does the US lag behind other countries with providing quality end-of -life care?  Why are Americans so afraid to die that we run to hospitals and expect extraordinary care for ourselves and loved ones?  Why can't we let go naturally?  Should there be an End-of Life Nurse Practitioner specialty educated in the best practices for pain relief and comfort for the patient and the family, able to provide psychological support to the survivors and the dying and death with dignity, comfort and grace?