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Decision to withhold or withdraw support.

This decision-making process is inherently uncomfortable. The recognition and open discussions of the issues are relatively new. There is legal and practice precedent for withholding and withdrawing therapies and support. Institutions must now abide by Joint Commission guidelines while individual physicians are permitted to practice within their own conscience. Patients' best interests must be served, but it should be accepted that permitting the dying process to evolve while attending to comfort is not only an acceptable but desirable strategy. Finally, physicians must play an active and pivotal role as the facilitators of proper care. The details of proper medical care should be physician prescribed.