This is based on opinion. Please don't list it on a work's trope example list.
Tearjerker / My Name Is Earl
The scene where Earl is in a coma and his condition is failing. In fact, as evidenced by being almostPut on a Bus in the Dom Com playing in his head, he actually is dying. And Randy is talking to him while Bob Dylan 's "Knockin' On Heaven's Door" plays in the background.
It's hard to feel sorry for Joy, but two episodes might get you a little misty. In one, she's losing her dreams of fame as "Reflections" (Diana Ross) plays on the soundtrack. In the other, she's watching her kids play at a function where she's not invited, while Bob Dylan's "Just Like a Woman" plays. She asks Earl if she's a bad mother and sounds utterly defeated.