How would our prescription play out? After doing diligence throughout hospitalization, the physician concludes that cardiopulmonary resuscitation (CPR) is not medically indicated: “Mrs. Smith, when we started this trial of therapies, we discussed that even the best medical care sometimes does not lead to a result that your husband would want. I’m afraid that he has reached a point, where if his heart stopped, CPR (described) is likely to extend his dying or promote a life that he would find unacceptable. When patients reach this point, very few survive hospitalization and the few survivors are often in very bad shape. I recommend that if he passes on, we do not perform CPR. Would he agree?” If the patient or surrogate demonstrates hesitation, then you have more explaining to do. Consider strongly additional opinions from other practitioners to confirm your impression because we are not nearly infallible. Consider requesting assistance from the ethical committee if the patient disagrees despite your diligence. If you have invested the time to communicate throughout hospitalization, most patients/families trust that you are doing your best. Most often, informed consent is reached and the discussions are documented in the medical record.