Multiple theories and models of decision-making have been reported in the popular and scientific literature. Decisions and choices about health care are some of the most dramatic and difficult that humans make. The interactive role of patient and health care professional in circumstances of urgency, stress, and possible unpredictability is complex. This article reviews some of the theories of decision-making and their implementation or usefulness in the end-stage renal disease setting. In caring for patients, health professionals need to identify their approach to the decision-making process with special concern for the patient role in this process.