Abstract
Because hospital intensive care units are in some ways the epitome of modern medical technology, they are often the focus of the questions that physicians and nurses must ask themselves from time to time about the very reason for their existence. Anguished relatives wait in the wings, expecting and fearing that death will come and sometimes disappointed that it does not. In an attempt to relieve unbearable pressures, physicians who are in charge of intensive care units are tempted to assert their sole right to determine when life has lost its meaning for their patients and to decide when care can be given over, and the plug pulled. It was easier 30 and 40 years ago in the days of therapeutic nihilism. Then, for many more patients than at present, the matter seemed to be out of our hands. There were fewer decisions to be made, and a gentle manner