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Palliative Care is an approach that improves quality of life of patients in complex situations with life-threatening illness. The relief of suffering is important. In this meaning palliative care has a lot to do with symptomatic therapy, because we can't treat the underlying illness. In spite all of that the knowledge of the illness, its possibilities of treatment and its prognosis are important to know, if we want do take good and wise decisions. With three examples I would like to show, how different decisions about therapies can be of the illness. The neuropathic pain can derive from different aetologies. There are multiple options of therapy, but we don't have a good test to predict which therapy will fit for which patient in pain. We have only one evidence-based pharmacological treatment of dyspnoea, that's morphine. The decision whether to give or not nutrition to a patient with advanced cancer or advanced dementia seems to be a difficult one. But if we have a look into the literature it's much easier to decied, because there is almost no advantage for the patient if we nourish him.