Critical care nurses face ethical issues every day in relation to end-of-life decisions. This article presents a case study involving the administration of a neuromuscular blocking agent prior to removing a patient from the respirator. The decision to use a paralyzing agent caused an ethical conflict between the nurse and physician. The article discusses ethical principles in relation to end-of-life decisions from the nurse, physician, and family's perspective. Whatever the belief, critical care nurses must consider the belief's of the patient and family while trying to maintain their own convictions.