Faced with the prospect of living out his days in a rehabilitation center, 32-year-old Tim Bowers chose on Sunday to remove his breathing tube and mechanical ventilation, ending his life less than a day after a severe spinal cord injury left him paralyzed from the shoulders down.

The decision to end life support came only hours after physicians informed Bowers’ family of his poor prognosis. Bowers, who had sustained his injuries during a deer hunt in the Indiana woods, was brought out of sedation to make the call himself. When his doctors told him that he would neither walk nor breathe on his own again, Bowers shook his head, indicating that he would rather die than live a life marked by surgeries, partial rehabilitation, and loss of contact with his wife and unborn child.

"We just asked him, 'Do you want this?' And he shook his head emphatically no," Bower’s sister, Jenny Shultz, told the Associated Press. “No outcome was ever going to be the one that we really want, but I felt that he did it on his terms in the end.”

Bowers lived out his final hours in the company of 75 friends and family members, who had gathered in the hospital’s waiting room to sing songs and pray. "I just remember him saying so many times that he loved us all and that he lived a great life," said Shultz. “At one point, he was saying, 'I'm ready. I'm ready.’”

Shultz, who is a trained nurse, knew that the poor prognosis associated with her brother’s injuries was something he could never endure. Earlier that year, Bowers had told his wife, Abbey, that he would never be able to spend his life in a wheelchair. Now, with three crushed vertebrae preventing him from ever again pursuing his lifelong love for the outdoors, Bowers presumably found himself with a single option.

Today, doctors and medical ethicists are working hard to develop new ways of facilitating unthinkable decisions like the one Bowers and his family was forced to make. For example, researchers from Case Western University recently announced the Electric Surrogate Decision Maker Resource and Tailored Training (eSMARTT) – a new type of technology that helps families of patients on life support with simulations, data synthesis, and other types of decision coaching. According to the developers, the avatar-based technology also nurses, who can use it to access medical records and practice patient interaction.

Still, the patient and her family members will always have the last say. “We give patients autonomy to make all kinds of decisions about themselves,” said Paul Helft, director of the Charles Warren Fairbanks Center for Medical Ethics in Indianapolis, Ind. "We've recognized that it's important that patients have the right to self-determination."