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This Article is thus an exploration of the essentials of the human personhood in community, both the intimate community of family and close friends and the larger, more impersonal community of hospitals and health care providers, courts, legislatures, and lawyers. After undertaking an analysis of the sources of the autonomy model for decisionmaking in this area and the negative consequences of an exclusive reliance on that model, this Article will propose a new moral, legal, and medical framework for making medical treatment decisions for incompetent incurably ill adults. This model both provides maximum opportunities for each individual to determine for himself, without state interference, whether, and under what circumstances, he should receive life-sustaining medical treatment. Simultaneously, it recognizes that because all individuals are persons in community, decisionmaking in this area must promote and respect the connectedness of the human family by providing incentives and opportunity for conversation and compassion.