As a nurse in the picu there are many times when I question the physicians decision to order physical and occupational therapy. For example, I took care of a patient with advanced stages of brain cancer. She was ventilator dependent and when she was evaluated for brain activity there was a consensus made that she would probably not survive for more than one month. The mother was in denial and she believed that her daughter was going to receive a miracle from God. Our physicians, despite their greatest efforts, did not succeed in convincing the mother to remove her child from life support. The mother insisted that her child receive physical and occupational therapy. As much as I sympathize, I can not support the physician’s decision to fulfill her wishes. Family centered care is getting to the point where the appropriateness of care is getting lost. Any clinical support service (CSS) that is ordered unnecessarily adds to the cost and detracts from the ability of those that really need it. Clinical providers must be strong and withstand the pressure placed on them by parents. To further support this idea, I have noticed that providers will sometimes fall to the pressure exerted by parents to prescribe antibiotics despite the physician’s knowledge that the patient is probably infected with a virus. Fortunately today, providers are becoming better at warding off these requests by explaining the dangers associated with increasing antibiotic resistance. Providers need to have the same level of tenacity when it comes to ordering expensive clinical support services to patients that will statistically never recover. I am not suggesting that patients whom have a remote possibility to reasonably recover, even in slight ways, not receive rehabilitation, but I do think that nearly brain dead patients should not be receiving physical and occupational therapy.