floor. The emergency team administered IV fluids and oxygen, then contacted the patient's only living family member, his daughter. Upon her arrival at the hospital, the daughter was greeted by an unfamiliar physician in the hallway outside her father's room. After a brief condition report, she was asked if she wanted her father to have CPR and advanced life support if his condition deteriorated. Mr. W's daughter was alarmed and puzzled. She and her father had never discussed his wishes. How could she decide? This is a common scenario: critical illness impedes the patient's ability to participate in decisions about treatment goals and options, and the patient'sautonomy is compromised. When a critical care plan has been prepared in advance, however, patients can make their goals and preferences known beforehand. Such planning can help to preserve the patient's right to determine how his health problems will be managed, even if he becomes too ill to speak for himself.