In this case of Complex Ethics Consultations: Cases that Haunt Us, the author recounts an ethics consultation involving a 70-year-old Roman Catholic nun in the cardiac ICU after emergency bypass and mitral valve replacement. As difficult postoperative complications began to resolve, including her respiratory function, the patient indicated that she wanted all treatments stopped, but in the past she had accepted treatments after initial reluctance. She pointed to her trach, saying she wanted it to be removed. Upon questioning by the ethics consultant, her discomfort was with the tube, not the ventilator per se. Reducing the diameter of the trach tube eased her comfort and she consented to a two-day trial. She was subsequently weaned from the vent. The author reflects on professional boundaries in ethics consultations and the risk that ethics consultants can inadvertently become stewards of the "culture of death" when they make premature assumptions.