A dispute arose among hospital staff members regarding the ongoing use of ECMO (over several months) for a young woman with lung failure following stem cell transplantation and the development of multiple lung infections, as well as pulmonary hemorrhage. The patient was not a candidate for lung transplantation, and few believed her lungs could recover to allow separation from the circuit. Some staff members felt that continued use of the scarce resources associated with ECMO (machinery and highly specialized personnel) could not be justified. The patient and family repeatedly indicated a desire to prolong life as long as possible. The case prompted three separate requests for ethics consultation and raised multiple issues surrounding resource allocation, management of tense patient-family-staff relationships, and the institutional status of the ethics consultation process. The reasoning and recommendations of the ethics consultants challenged established power and authority within the institution, making the situation uncomfortable for all.