The right-to-die means that the terminally ill person has the right to refuse further treatment. The duty-to-die means that terminally ill persons feel that they have no choice and must refuse treatment because of social factors such as family burden or financial cost to society. This article describes the perceptions of a sample of 72 Japanese nurses and 71 counterparts from the West. The right-to-die received support from all of the western and from a majority of the Japanese sample. However, the duty-to-die received weaker support from the West and rather strong disagreement from Japan. Themes emerged in the two groups from a content analysis of their reactions to the major concepts of right-to-die and duty-to-die, and these included autonomy, values surrounding life, justice, family as a possible coercive agent and family as a partner in decision making. Differences and similarities across the cultures in the meaning of these themes were explored.