The major ethical challenges for critical care medicine in China include the high cost of patient care in the ICU, the effect of payment mechanisms on access to critical care, the fact that much more money is spent on patients who die than on ones who live, the extent to which an attempt to rescue and save a patient is made, and the great geographical disparity in distribution of critical care. The ethical problems surrounding critical care medicine bear much relation to the culture, public policy and health care system in China. The essay concludes that China should allocate more resources to ordinary medical services rather than to critical care medicine.