Patients with critical illness that can no longer be cured medically (end of life) have complex problems and require a palliative therapy approach. Palliative therapy is a holistic therapy that requires a medical, cultural, spiritual and psychological approach to both patients and their families. Spiritual Islam has the concept of Husnul Khotimah or a good end to life. The end of a good life one of which is to accept pain and keep worshiping during illness as indicated by the spiritual value of Nirvana. This study compares the spiritual value of patients in intensive care rooms (ICU) who died and lived based on the spiritual status data of medical records of patients treated using mechanical ventilators in the ICU at PKU Muhammadiyah Gamping Hospital. The results showed that more patients died and their spiritual status could not be assessed than those who lived and had spiritual nirvana value (p <0.05). Of patients with spiritual nirvana value, there were no significant differences between the sex of patients who died and lived in the ICU (p> 0.05). Differences that can’t be assessed spiritual status is likely because when it comes in an unconscious condition and immediately died, while patients who live in the ICU are then moved to an ordinary room.