The aim of this cross-cultural qualitative study is to explore how adults with cancer decide to forgo or stop active treatment, and what issues arise for them, their families, and the treatment team, as a consequence of such decisions. Individual interviews and focus groups have been used to generate narrative data for phenomenological description and cross-cultural (Australia- Israel) comparison. In this paper we present selected results from the preliminary data analysis. Patients’ decision to forgo or stop treatments such as chemo or radiotherapy challenge physicians’ and other health professionals’ perceptions of themselves as acting in the patients’ best interests and of providing the best possible care. Patients value medical advice, but also balance issues such as past experiences, knowledge of their condition and treatment options, prognosis, anticipated quality of life, fear of suffering and pain, the impact of their illness and its treatment on their family’s quality of life, and the need to preserve their sense of bodily and personal integrity. Support from family members and medical staff is critical to the patients adhering to their initial decision over time, but they also report considerable pressure from friends and physicians to change their minds. The most valued support from medical staff is a promise that they will not let the patient suffer pain as the disease progresses and moves into terminal phase. Preliminary results suggest that the medical system in Australia may be more accepting of the patients’ decisions to forgo treatment than is the case in Israel. Our ongoing research is aiming to uncover cultural and other factors that might help to explain these differences. The results of this study will inform palliative care services in the provision of care to patients whose decisions may have challenged the medical ethos of active treatment, and whose relations with family and medical team might have been affected in the process.