Abstract Recent decades have seen dramatic improvements in our ability as a profession to care for patients with critical illness and chronic disease. One consequence of this is that patients now more often survive to a point where nutrition becomes a limiting factor in their care. In addition, we now have the skills and technology to maintain a patients' nutritional status indefinitely. Taken together, these factors have significantly raised the profession's awareness of the ethical dilemmas involved in the provision of artificial nutrition. This short article suggests one approach to these vexed questions.