Since late 2024, Westminster has debated whether and when English and Welsh patients may hasten their deaths. But what about the opposite situation? How should we handle situations when the patient wants to live but their clinicians determine that continuing life-sustaining treatment is inappropriate, non-beneficial, or therapeutically obstinate? These sorts of conflicts have long been common in NHS hospitals. Yet, they are increasingly prevalent as families dispute even long-settled medical concepts like brain death. Normally, clinicians defer to patients and families when the decision is value-laden and preference sensitive. But surely, clinicians need not comply with “any” demand that patients and families make. What are the proper limits to clinical deference? And how should those limits be adjudicated?