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Although having my suspicions, I was unaware of the evidence demonstrating that many patients with advanced cancer do not understand the purpose of the chemotherapies they undergo. It was routine in my work as a Federal State Attorney, dealing with health claims, to see patients who demanded a specific treatment in the hope of curing their cancers, but who subsequently got worse and died shortly after starting such courses. Was it really health we were talking about? Or was it actually hope? Completed in early 2019, this was the central question addressed in my doctorate. Realizing that the Brazilian judicial scenario was just a micro example of a much broader reality, based on the literature and complementary doctoral research done in Germany, I resolved to publish the results of my PhD research in English. In order to meet the needs of an international audience, I completely revised the original thesis, which had already been published in Portuguese, included new chapters, and contextualized the few references to the Brazilian ethical-legal context that is maintained in the present text. A further inclusion is a whole chapter about the qualitative research carried out on patients in Brazil and Germany. I believe that this is a book with an unprecedented approach to the mistaken expectations of cancer patients and that addresses the consequent questions of autonomy and dignity. As such, I sincerely hope that its publication will be useful for, still incipient, end-of-life discussions and contribute to strengthening the idea that universal access to palliative care should be seen as a medical necessity – and not an occasional eventuality depending on the training of the health team and the wishes of patients and their families.