Rapid advances in technology enable the preservation of life beyond its natural means. The Patient Self-Determination Act and the passage of Act 169 in Pennsylvania help to address these technological advances and provide guidance to individuals regarding their right to accept/refuse medical treatment and/or execute an advance health care directive. Providers are often confronted with legal and ethical challenges regarding end-of-life treatment decisions, such as the withdrawal or withholding of life-sustaining treatment. We help providers develop practical responses to these challenges, including the establishment of ethics committees. We also are sensitive to conscientious objections and possible moral constraints in instituting policies on the withdrawal of life-sustaining treatment, particularly nutrition and hydration. We assist providers in developing policies and procedures regarding health care treatment decisions and advance health care directives that are compliant with state and federal law.