At first, it seems that physicians might have a responsibility to recommend goals of care for dying patients in the ICU. I suggest this is mistaken. Not only do physicians usually have no such responsibility to recommend goals, it is even a mistake if they do. Usually, the next of kin or other surrogate is the decision-maker in such cases, but regardless of whether it is a still-competent patient or a surrogate, many bad things can happen if physicians try to recommend treatment goals. If surrogates decide, they should pursue what the patient would have wanted, if known, and otherwise what is in the patient’s best interest.