To the Editor: I was struck by the sensitivity and concern for patients expressed in the recent paper by Imbus and Zawacki (N Engl J Med 297:308–311, 1977). The tone of the article was so warm and the sentiments so obviously genuine that I read it repeatedly.The authors state that when a patient enters their burn unit with an injury so severe that survival is unprecedented, the patient is allowed to decide whether the team should go all out or remain supportive. It is obvious that major barriers had to be overcome to allow a highly motivated team . . .