These lectures will address the neuroanatomy and neurophysiology of early-on-illness and injury related to clients with potentially devastating brain injury. Early withdrawal of treatment in early and later decision making for surrogate decision makers will be explored by discussing internal values, external values, and the window of opportunity in decision making. A shared discussion between the experts with bring the learner to consider the uncertainties of what clinicians, family members, and shared decision makers are forced to explore and how diagnostic techniques may assist in prognostication for these decisions.