if known ( Beauchamp & Childress, 1994 ). Since the passage of the Patient Self-Determination Act, patients have legal rights to make health care decisions. Some patients have made advanced autonomous choices about their care at the end of life. These advanced directives or living wills, including do-not-resuscitate orders, are intended to reduce aggressive interventions. However, research has found that when patients have advanced directives, they are more likely to have more invasive and expensive care than patients without an advanced directive ( Teno, et al., 1997 ) thus illustrating that their a priori wishes are ignored, primarily after the patient becomes incompetent. Care for dying patients with wounds consists of: Care that should be provided Care that should not be provided. Care that can be considered optional. Health care providers together with patients (and their families) should make decisions on the merits of a particular intervention or treatment. Determining whether a specific aspect of wound care is to be provided hinges on balancing benefits with burdens (including harms and risks). In all cases, patients' choices must be respected. However, if the patient is not competent and there are no advanced directives, then the intervention would be considered obligatory and should be provided. For example, treatment measures to relieve distressing symptoms, such as pain associated with a wound, should be provided. Conversely, treatment should not be provided if: The competent patient refuses the treatment. The treatment is considered futile or clinically inappropriate. For example, if the treatment will not fulfill