Studies demonstrate that when faced with an identical patient, different hospital-based physicians very significantly in their decision-making regarding the benefit of admission to ICU. As a Senior Palliative Care Physician, the inclination is to say a definitive ‘NO’. However, things are always more complex than they seem on the surface. This presentation outlines the complexity of decision-making in sending elderly cancer patients to ICU, where successful outcomes have only been measured in terms of survival benefit, not effect on remaining life. Survival outcome seems to depend on the reason for admission (medical vs surgical), the need for mechanical ventilation, the use of vasopressors, the presence of comorbidities, and the presence of organ failure, rather than the extent of metastatic disease per se. Data from the Lyell McEwin ICU demonstrate that a cohort of elderly cancer patients have an excellent outcome from an ICU admission. Find out if this Palliative Care Physician is a heretic...