Imagine this: You've just resuscitated, tubed, and lined a 65-year-old woman found unresponsive in her home. A CT confirms a large hemorrhagic stroke, and you pause-knowing the likely clinical course to follow. Her family arrives, sharing stories of her fierce independence and her "great health" prior to this event, mumblings of "she would never want to live like this" stir around the room. Now what? When invasive ventilation does not align with your patient's values, how do we guide the next steps with clarity, compassion, and control of the situation? This engaging session will equip you with practical tools for having clear and compassionate conversations with families, explore when and how to consider palliative extubations in the emergency department, and walk through how to create a smooth, comfort-focused medication and care plan.