The rising costs of health care coupled with the dramatic increase in the number of individuals over the age of 65 years presents the health care industry with the dilemma of an increased demand for services and goods, with limited resources. Physicians, economists, and ethicists have suggested various solutions to this problem, including the controversial proposal strongly advocated by Daniel Callahan, of age-based rationing. This article explores some of the issues that are woven into the allocation of health care resources based on age. Although there are no easy answers to this dilemma, the critical care nurse needs to be familiar with these issues to function effectively as a patient advocate. Some suggestions to enhance this aspect of critical care nursing will also be discussed.