Introduction: Ethical decisions face the modern surgeon every day. There is a growing movement of surgeons who openly will not respect the wishes of their patients when they want to live. This sentiment has grown from personal perceptions of quality of life, considerations of financial burdens, reflections of personal quality evaluations, amongst others. This case study explores the ethical considerations challenging the Christian Surgeon in daily care including the challenges of disapproval. Case Study: The patient is a 60-year-old deaf woman who presented with a hypertensive crisis and an aortic dissection. The aortic dissection resulted in renal failure. Her medical management included blood pressure management and dialysis for her renal failure. Evaluation by vascular surgery determined her aortic dissection was not amenable to operative intervention. General Surgery was consulted for a bowel obstruction. Before any operative intervention was attempted a lengthy discussion with the patient, her son and daughter, and a hospital interpreter was conducted. The consensus of this discussion indicated the patient and her family wanted everything done. Operative intervention resulted in the removal of the majority of her small intestine for ischemic bowel with multiple perforations. An entero-cutaneous fistula complicated her post-operative course however this has subsequently resolved this complex issue. She eventually did well and was discharged to a rehab unit. During her ICU stay the Surgical ICU attending felt any further intervention in this self-aware patient was futile and refused to see the patient either on daily rounds or participate in any way in her care. Discussion: Considerations include; implications of respect for the individual desire to live, implications on respect for the personal discussions, implications on respect for physician time and the lack of coverage.