Advance directives are statements made by a person who is capable of making decisions regarding health care choices that need to be applied at a future time when the person may no longer be capable of decision making. A patient may present a life-threatening condition with an ambiguous advance directive, and a delay in decision making could compromise the patient outcome. This article describes a case and includes an analysis of a situation where there is an ambiguous advance directive. Suggestions to the critical care nurse are provided.