<p>Many years of practice as critical care nurses indicated to us that doctors, nurses and relatives suffer because they are involved in, or are affected by, interactions about end-of-life decision-making. It seemed to us that the way the interactions were managed inevitably caused avoidable suffering. Relatives and nurses were angry or confused because they often perceived that they were excluded from decision-making and doctors were distressed by their perceived lonely burden. This led to a recently completed study (hereafter called the end-of-life study) concerning the interactions involved in end-of-life decision-making (not yet published).</p>