This article discusses how an art therapist working in a hospital palliative care unit has incorporated a ritual of hand casting to help bring closure to dying patients and family members who are grieving as death approaches. The finished hand sculptures depict the hands of the patients and, sometimes, of their loved ones. They are faithful and powerful representations that help dying patients and leave meaningful legacies for their family members. This paper reviews the historical perspective of how artists have used various media to represent the human body, both living and dead, and presents three case examples that illustrate art therapists' use of hand castings to address issues of grief and loss in palliative care. (Contains 8 figures.)