In this article, part of a special issue on meaning in life and medical ethics, I argue that several issues encountered in a bioethical context are not adequately addressed only with values such as morality and welfare. I maintain, more specifically, that the value of what makes a life meaningful is essential to being able to provide conclusive judgements about which decisions to make. After briefly indicating how meaningfulness differs from rightness and happiness, I point out how it is plausibly (...) central to making decisions in six ‘life and death’ matters. My aim is not to draw any firm conclusions about what to do when it comes to these topics, but rather to show that in order to arrive at any, one cannot plausibly ignore the category of life’s meaning that has, until recently, been nearly absent from Western bioethics since its inception. (shrink)