In this article, I discuss depression, anxiety, and delirium in the context of terminal illness. These highly prevalent disorders are frequently underdiagnosed in this setting. The failure to diagnose and treat them may subsequently prevent “quality dying.” Death is not a good thing, to say the least, but sooner or later it comes to us all; when it comes to our patients, we need to do a better job of providing the highest quality of care. Provision of a “good death” is one of the major goals of the Educating Physicians on End-of-Life Care (EPEC) curriculum and is perceived as more and more important by the public and the medical community. Although many physicians are comfortable dealing with depression and anxiety in a routine ambulatory setting, the context of a terminal illness requires different approaches to assessment and management of these disorders, as shown in the following summary of a patient encounter.