If it is true that a sizeable number of the ill live out their last days peacefully, then others are otherwise thrown into an indescribable state of anguish. How can such variation be explained? Can we intervene more efficiently? The theory of terror management through self-esteem, formulated in 1986 by Solomon, Greenberg and Pyszczynski, offers a coherent theoretical framework and potentially provides leads for intervention pertaining to the practice of palliative care, which we shall attempt to explore in this article.