We commend Drs. Edwards and Tolle [1] for their contribution to the subject of withdrawal of care. However, the role they chose to play in disconnecting the ventilator and the subsequent emotional reactions they suffered should not be considered as typical when appropriately withdrawing care.

The emotional turbulence they described may be more directly related to the circumstances surrounding the death of the patient. It is significant that they carried out this final and most profound act of treatment for a patient who was not even under their direct care.

The ethics consultants were thrust into withdrawing care with no time to prepare emotionally. The withdrawal of life support, no matter how justifiable and well considered, is always emotionally demanding. A lapse of several days from the time one agrees to discontinue life support to the actual implementation allows the patient, the patient's loved ones, and the health care team to prepare for the death and their role in it. Further, it should be explicitly understood that the decision to proceed can be altered at any time.

Another component of this case could explain the immediate anxiety and subsequent guilt experienced by Drs. Edwards and Tolle. Quite likely, they were enraged with the primary attending for being absent and thereby abdicating his or her duty to withdraw treatment. Such intense feelings, when combined with presiding over the final passage of a fellow human being, can easily give rise to the emotional confusion and turmoil they described. Although Drs. Edwards and Tolle apparently were compelled to act out of a sense of beneficence, it was inappropriate for them as ethics consultants to step in for the primary attending.