To me, a critically ill child is one who is recognized to be in danger of dying. Many children who die have chronic debilitating disease. How does one prepare the child, family, and those who care for the child for imminent death? Is it ever possible to consider the support of life unethical? The crisis of curable illness does not immediately beg any of these questions. When the physician is faced with an acute manageable condition, he must react with speed and intelligence. Even if he is quick with his reaction and intelligent in his decisions, he faces problems. The physiology of life processes must be supported. He must support metabolism, circulation, respiration, and the function of the central nervous system. He must eliminate offending agents and be certain that the drugs and techniques he uses are appropriate and their dangers less than their therapeutic effect. He faces another problem.