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Most hospitals are facing the dilemma caused by demand for critical care beds outstripping supply. This imbalance is likely to get worse over the coming years as a result of many factors, including aging of the population, improved technology, and improved therapies, among other factors. As a result we are likely to have to make further tough decisions about rationing of this service. In this issue of Critical Care, two authors debate the appropriateness of providing life support in accordance with a family's wishes to an individual who is unlikely to survive admission to the intensive care unit. Understanding both sides of this debate is an important aspect of an intensivist's job

critical care

Pro/con clinical debate: life support should have a special status among therapies, and patients or their families should have a right to insist on this treatment even if it will not improve outcome.