Crises such as a global pandemic seemingly challenge our ethical values and principles by constituting a state of exception; however, it is arguably during just such crises that we must maintain ethics as usual. One challenge is the potential need to triage scarce resources, raising the question of whether life-sustaining treatment may be unilaterally withdrawn from one patient to be made available for another during a surge. On one hand, the primacy of the physician-patient relationship demands that life-sustaining treatment not be withdrawn unless the patient or a surrogate decision-maker authorizes it, the burdens or risks of continued treatment are disproportionate to the expected benefits, or continued treatment would be physiologically futile—the same reasons as in everyday clinical situations. On the other hand, health care providers are obliged to be responsible stewards of available resources. By considering ethical principles such as double-effect, limitations on property claims, and jus in bello, I argue that, while eschewing utilitarianism, unilateral withdrawal of life-sustaining treatment may be permissible under crisis standards of care. Nevertheless, in preparing for the next pandemic, health care systems should invest in additional resources to ameliorate the need to make such tragic triage decisions.