There are multiple ethical conflicts, dilemmas, and sources of distress for nurses caring for people at the end of life that must be considered. There are individual patient care decisions and societal debates to which nurses need to contribute. Nurses experience ethical concern when faced with consensus-building activities to establish goals of care, uncertainty about capacity and/or patient wishes, futility, withhold/withdraw life-sustaining treatment decisions, aggressive symptom management, addressing concerns of significant others, and varied spiritual or cultural beliefs. There are implications for processes and levels of information sharing with other healthcare team members, patients, and families. Public debates about assisted suicide and euthanasia impact the individual nurse providing end-of-life care. Ethical principles, professional documents, and collaborative practice guidelines exist to address individual cases and to develop sound ethical nursing practice for patients at end of life. This article is an overview of those issues and resources.