The social, legal, and political discussion about the decision to stop feeding and hydration for Terri Schiavo lacked a medical ethics assessment. The authors used the principles of medical indications, quality of life, patient preference, and contextual features as a guide to medical decision-making in this case. Their conclusions include the following: (a) the use of a feeding tube inserted directly in to the stomach constituted artificial treatment; (b) the treatment prolonged biological life but did not lead to a cure and did not restore health; (c) quality of life was absent for the patient, with no sensation and no motor or cognitive functioning; and (d) by preponderance of medical opinion, she would have chosen not to live in a persistent vegetative state. The authors find the withdrawal of treatment was permissible and correct. It was not a choice between living and dying, but a decision of when to allow dying consistent with the patient's choice.