Six million Americans are admitted to an intensive care unit (ICU) each year. Many receive aggressive efforts to return them to health that are appropriate and consistent with their values. Others are treated aggressively, despite a poor prognosis, even though many people indicate that they would not want burdensome treatment in such a situation. The term intensive care unit and its abbreviation, ICU, may contribute to this discrepancy by implying a default option of aggressive life-sustaining therapy.