My sister's husband is terminally ill. Before this hospitalization, he made my sister promise that she'd have the physicians "do everything." Now he's in the ICU, unresponsive, and ventilator-dependent. His physician says it's time to let him go, but my sister feels we should do more. Because I am a nurse, she's looking to me for answers. What should I do? - -P.C., Manitoba

The word "should" needs to be removed from our vocabulary. It could lead you to suggest something now, then be blamed for the outcome weeks or months later.

I'm sure you've supported your sister in many ways throughout this devastating illness. Now, the best thing you can do is to help her hear the advice from her husband's physician. Everything has been done. She's kept her promise but her husband's life won't be spared.

Find a quiet moment to sit with her and explain the terminal weaning process. Emphasize how a morphine drip will keep her husband comfortable. As her sister, you can also walk with her at the funeral, have tea by the fire, and listen to her memories.

For now, she mostly needs you to just be a sister.

Because I usually work in obstetrics, I'm rarely involved in issues of death and dying. Last week though, I cared for a mother who'd been admitted after a car crash that killed her little boy. I didn't know what to say except that the accident wasn't her fault. Do you have better words? - -D.M., Tenn

You did just fine. Since the beginning of time, a mother's role has been to protect her children. But sometimes that isn't possible.

I recall being asked to speak with Margaret, a young woman who'd been driving a car with her two children properly secured in the backseat. Suddenly the driver of a dump truck traveling ahead of her inadvertently hit a lever that released the tailgate. In an instant, a ton of stones sprayed across the road. Margaret lost control of the car, which flipped several times. Although Margaret suffered only minor injuries and her son survived, her daughter died immediately from neck and spinal cord injuries.

I found Margaret bruised and battered, her arm in a sling. She was weeping.

"Margaret, my name's Joy and I do grief counseling. Do you want to talk about the accident?"

She nodded yes.

"What happened, Margaret?"

She told me the story.

"I'm so terribly sorry your little girl died. It's important for you to know that this wasn't your fault."

"My husband's going to hate me."

"How can he blame you? Once the car hit the stones, physics took over. Not even a professional race car driver could have controlled a car in those circumstances." She looked into my eyes, considering that fact.

"Margaret, I think guilt is a wasted emotion here because you were doing the best you could.

"This was a horrible accident. I'm so sorry for your loss. But we can't lose you too. Do you understand?"

She wiped her eyes with a ball of tissue and nodded yes.

Then she grasped my hand and asked me a question.

"What do I say-what do I say when somebody asks how many kids I have?"

"You say, 'I have two children. One has died.'"

"Thank you," she whispered.

Sometimes we keep grief around because it helps to keep the loved one alive in our memory. But guilt serves no such purpose.

I'll never know if my words eased any of the pain in this woman's broken heart. I hope so, because guilt can kill.