We live in an amazing time. Advances in medicine and technology have given doctors the power to save lives that would almost certainly have been lost in the past. But such advances in life-saving techniques have their downsides as well. As numerous courts have recognized, doctors now have the power to preserve life—or at least the physiological attributes of life—past the point at which many of us would care to live. As medical professionals’ ability to preserve life increases, so do conflicts concerning whether such treatment should be rendered. The litigants in such contests include family members, medical institutions, the person whose possible death is at issue, the state, and occasionally, even total strangers. The task of making decisions in these contests often falls to judges. These contests at the twilight of life and death, and the roles that various actors in the legal system take in resolving them, are the subject of this Article.