So 21st century medicine fails all parameters necessary to minimize risk in framing: Prognostic models are weak, our knowledge of even available data is nonuniform, our reasoning is befuddled by heuristics and biases, medical practice is often affected by exigencies (eg, bed availability), and few have the extraordinary amounts of time to guide patients through this complex journey of truly informed consent. Some even withhold information. To frame, to mold (or, more cynically, to manipulate) patients’ end-of-life decisions in this milieu could promote arbitrary results. Envision a system where a physician may frame for palliative care on Sunday, and on Monday, with a change of service, the new covering physician frames for full steam ahead. Although this likely happens now, to invite framing might exacerbate interprovider variability. And “advice” is labeled framing, whereas covert or unconscious/subconscious framing is, arguably, a greater threat to patients’ autonomy. It is plausible that health-care disparities are partly promoted by framing (eg, if some effective interventions are not offered to some patient groups). To legitimize framing without ensuring the skills and insights necessary to safeguard from abuses might increase disparities. What makes reasonable sense in a thought experiment or the confines of a carefully performed trial could have unexpected (and profound) consequences applied in the real world.