There is nothing in the heart-rending outpouring of emotion that followed John Hartford’s death from ALS that speaks to his dignity, however finely honed. He did not fight death. He was not given months to live, though it was hard to imagine any human being willing to endure that indignity. The theme of Hartford’s story has been the carelessness of those who remained at his side after, unfortunately, those he loved began to leave him. He was placed on hospice at D.C. General Hospital, where they treated him with deference and decency, as did his family and friends, who were ready to do whatever was needed. It is the Medicaid bureaucracy in the District of Columbia that deserves the blame for Hartford’s death, or at least the written manslaughter verdict for participating in such actions. It is the state that has become an arena of lawsuits and expensive appeals. The state that Hartford died in, yes, but the Medicaid bureaucracy that permeates the District. The horror story of the two weeks that followed the D.C. General diagnosis has made it so that many patients no longer see the problem of blindness or ALS as someone else’s responsibility.