An ethics consult was scheduled for the following day. Prior to the consult, Mr. Hope subsequently decompensated and was transferred to the local hospital. The ethics consultation service continued with the ethics consult to discuss the ethical concerns of the medical staff but in particular to create an open forum for the staff to process their moral distress over the care of this patient and to come to an agreed-on plan on how they would proceed should the resident code. The patient never returned to the long-term care setting. While in the emergency room, the patient took a turn for the worse and appeared to require intubation. The emergency room attending physician contacted the patient’s family and discussed the imminent likelihood of the patient’s demise and the potential harm caused to the patient by resuscitation and intubation, and the family agreed to switch to comfort measures, allowing the patient to pass peacefully. The family stated to the ER physician that they needed to feel as though they had done everything they could to keep their loved one alive and did not want any responsibility for his death. The staff at the long-term care setting still remember Mr. Hope in their daily work and talk about him often.