 Consider the decision to accept death rather than a certain form of treatment. The desire to die can, of course, be a sign of mental illness in certain cases and so possibly a sign of incapacity (though merely being mentally ill doesn’t make someone incompetent: see  §5.5).  But it would be hugely problematic to view all refusals of life-sustaining treatment as indicative of either mental illness or decisional incapacity (or both!). Some people refuse life-sustaining transfusion of blood for doctrinal religious reasons (Charland 2001: 137). Others may choose death as a preferable alternative to suffering. For example, a long-term dialysis patient who is not a candidate for transplant may accept death as the only way to escape from an existence she finds unbearable. Such a choice is intelligible even if it is not the choice most dialysis patients make. In both the religious case and the dialysis case the choice appears to reflect values that are not shared by all people. Yet disagreements about values, troubling though they may be, are not generally thought to be indicative of any lack of mental ability. Since death can be chosen by competent individuals as well as incompetent ones, many theorists have argued that we must look to something other than simply what is chosen to distinguish competent choice from incompetent choice.