[Between the poles of life and death]

Sometimes, conditions of critically ill patients unable to communicate, force us to decide whether or not to continue treatment. The most frequent elements we have to consider in individual patients, are survival at any cost and reduced future physical functioning and quality of life. In this article, we highlight existing literature's inability to precisely determine a given patient's preferences or to guess what they might be. Confronted with this crucial decision, the intensivist must therefore avoid the misstep of imposing their own values and expectations upon the patients. Patients even when unable to communicate must remain the master of their own destiny through their health care surrogate. If the question of their values and expectations, their advanced directives or their health care surrogate have been addressed or evoked beforehand by the family doctor, the chosen treatment modalities taken by the parties involved at a critical moment will thus allow the patient to remain the main actor of his care and destiny.