The concept of protherapeutic authoritarianism, a critical notion in medical ethics, has received insufficient attention in the literature and remains underdeveloped even though 40 years have passed since the first significant publication on the topic. This article introduces a revised and updated framework for protherapeutic authoritarianism, one that is designed to identify factors influencing the conflicts that arise during life-sustaining treatment decisions. Specifically, the article pursues three objectives: first, it defines protherapeutic authoritarianism and traces the evolution of that concept;second, it explores studies on the forms and manifestations of conflicts within Intensive Care Units;third, it illustrates how protherapeutic authoritarianism may have contributed to the emergence of such conflicts.