Confronting difficult decisions.

Medical technology has given clinicians the means to sustain life past the time when such actions are prudent or wise. The existence of such technology does not always mandate its use. The decision to withhold or withdraw treatment must be based on diagnosis, prognosis, and the patient's wishes. Given the relationship between PAs, physicians, and patients, PAs are in a unique position to assist in the decision-making process. Continuation of care is an important consideration even when a specific therapy is withheld or withdrawn.