Insight into the experience of family-member decision making regarding treatment of incompetent ICU patients can be gained through an exploration of the literature regarding the ICU environment, normative bioethics, and the decision-making process (see Fig. 1). The review of these relevant bodies of literature has suggested the challenges faced by family members who are expected to be involved in these difficult decisions. Nurses, by virtue of their professional commitment to patient and family advocacy, have a responsibility to develop empirically based knowledge that can be used to assist family members as they face these challenges.