This article summarizes the convictions of a profes sional ethicist and director of a hospital-based bioeth ics institute with regard to decisions of clinical ethics, especially those surrounding care of the terminally ill.An ethical and legal distinction is made between refusal of treatment on the one hand, and assisted suicide and euthanasia on the other. However, no ethical distinction is maintained between withholding treatment or withdrawing it when it seems inappro priate.The importance of consent for all invasive medical treatment is emphasized, including all artificial deliv ery of nutrition and hydration. The rights of patients and legitimate proxies to refuse treatment on the basis of burdensomeness and uselessness are under scored.The importance of palliative care is noted, brain death is considered, organ donation is encouraged, and the article ends with a reminder that life is a basic, but not absolute, value.