Little is known about the structure and objectives of various hospital ethics committees due to their need to preserve confidentiality, their reluctance to reveal internal hospital problems, and their concern about becoming involved in the developing debate about the appropriate role and value of such committees. The evolution, functions, and goals of one distinctive hospital committee concerned with the care of the critically ill and dying are explained. Its membership and proceedings are described, and the medico-moral issues with which it has grappled are presented and discussed. An assessment is provided of the positive and negative impact of this committee within the Medical Center with which it is affiliated. The experience of this particular group illustrates that hospital ethics committees can play advisory and educational roles within a large medical center. They can provide support for patients, medical professionals, and families who face difficult dilemmas about terminal illness. They can function as forces to sensitize medical personnel to the challenges presented by medicine's growing power over death. They can serve as catalysts for interdisciplinary communication. Finally, they can promote the development of new programs for informed and humane care of the terminally ill.