Due to the severity of illness, death is not uncommon in intensive care units (ICU). Unfortunately, a major percentage of deaths in ICU are patients diagnosed with a terminal disease. Initiating discussions on the transition from curative care to palliative care can be stressful for doctors, patients and families. The challenge for doctors, is to maintain open communication and shared-decision making with patients and family members at this very sensitive time. This can be challenging due to the culture of ICU which focuses on saving lives rather than palliation. Facilitating discussions for terminally ill patients in ICU may enhance their end-of-life care and assist patients to die in an environment of their choice such as their home.