A baby is born prematurely at 23 weeks’ gestational age with many typical complications of extreme prematurity. At 47 weeks’ adjusted gestational age, she continues to receive ventilation, is fed through a nasal-duodenal tube, and has grade IV bilateral intraventricular hemorrhages resulting in global encephalomalacia. Her parents are counselled that she has a “poor prognosis” and a decision needs to be made about whether life-sustaining treatments should be continued or stopped.