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Some of the issues which nurses confront when they deal with the disclosure of terminal diagnoses and prognoses to patients are explored In such circumstances, the nurse must respond to the competing demands of patients, relatives and medical staff The paper examines the way in which a group of experienced staff nurses in a general hospital accounted for their activities during and after the disclosure of a lethal diagnosis In particular, it explores the ways in which nurses are included or excluded from decision making about disclosure by medical staff