In a medical culture where death is too often viewed as failure, clinicians and patients struggle to have high-quality discussions about deactivating an implantable cardioverter-defibrillator (ICD). The implications of this inaction are not trivial. In approximately half of hospices over the course of a year, patients dying of incurable disease will be shocked by their ICDs.1 Multiple societies have made recent calls for increased communication around ICD deactivation.2,3 However, exactly what form those conversations should take has yet to be determined.