Critically ill patients who refuse life-prolonging therapy resemble suicides in that they choose death over life & are likely to manifest some ambivalence about their decision. 3 authors present their views over the issue of competency in the presence of ambivalence. Under changing conditions or “mid-process” ambivalence is both inevitable & appropriate evidence of rational deliberation. A case is made for coercive intervention. Decisions for the helper need to be based on the individual.