Despite being in existence for more than 15 years, the effectiveness of advanced directives has yet to be established. One possible reason for this is an inadequate level of shared understanding among stakeholders - the dying patient, family members and medical practitioners - regarding values and their implications for future actions at the end-of-life. Americans find it difficult and stressful to discuss death. This research investigates whether the articulation and alignment of values and meanings for the end of life can be promoted by framing them as acts of negotiation. This research uses ethnomethodology to examine the needs of this population, followed by grounded theory analysis of the interview data. The author concludes with three design guidelines for designing technology to aid in the exploration of options at the end of life.