For doctors, there are rarely easy decisions to be made when it comes to the care of someone who is critically ill. In some cases, a bleak prognosis may require them to advise a patient against continuing their treatment. Other times, they may see cause for optimism, however remote it may seem. Knowing how or when to make that determination is the tricky part. Michael Belkin, professor of surgery at Brigham and Women’s Hospital, and Nicholas Sadovnikoff, assistant professor of anaesthesia at Brigham and Women’s Hospital, participated in a discussion about treating patients who are nearing the end of life. Atul Gawande, Samuel O. Thier Professor of Surgery at Brigham and Women’s Hospital, is mentioned.