Care of the terminally ill is rewarding and challenging. Nurses have the potential to affect the quality of these patients’ lives. A recurrent theme voiced by terminally ill patients and their families is the nutritional ramifications associated with the cessation of nutritional intake. Various ethical perspectives provide a useful guide for decision making when determining whether fluids and nutrition should be continued in the terminally ill. This article will discuss various ethical perspectives in relation to nutrition cessation in the terminally ill. Basic physiologic changes that occur in the terminal patient will also be addressed. Nurses play an important role in insuring quality of care, particularly in supporting patients and families as they make decisions regarding nutritional management at the end of life.