A New Zealand High Court — in Maharaj v Te Whatu Ora of Auckland — recently granted an order authorising clinicians treating an incapacitated patient to withdraw a life-support machine from him. It did so on the ground that his condition was hopeless and based on the doctors' opinion that continued treatment was an inefficient use of limited resources that could be better used for other patients. It rejected the family's plea for continued treatment for a few more days, to allow it time to seek second opinions and to perform religious rites. These cases raise important issues: who is the ultimate decision-maker in disputed cases such as this, and on what criteria is the decision to be made; is a medical resource allocation decision a lawful justification for denying life-supporting care, and if so, are any conditions attached; is court approval (or should it be) mandatory before life support can be withdrawn when the family refuses consent; and, if court approval is required, whose task is it (or should it be) to ensure the matter comes before the court? Few cases have come before New Zealand courts in recent decades to help answer these questions. This article analyses the approach taken by the common law of New Zealand, Australia, Canada and the United Kingdom. It argues that Maharaj was a missed opportunity to consider comparative case law that has arisen since these issues were last addressed by the New Zealand judiciary, in particular two recent decisions of the Supreme Court of the United Kingdom, which have placed its common law on a more modern, patient-centred and empathetic legal basis.