Sixty-eight-year-old ruth suffers from advanced breast cancer that has spread to her lymph nodes. her doctors have told her that there are no more treatments they can offer her and have suggested that she consider enhancing the quality of the short time she has left instead of continuing to fight what will be a losing battle. she is not ready to give up on beating the cancer, and yet she seems to constantly mismanage her medications. she takes the wrong doses, sometimes takes the wrong pills, and occasionally "forgets" to take her medications at all. one afternoon, she makes such a serious mistake that the wrong pills interact with each other in a fatal manner. ruth's death would be an example of what shneidman refers to as: