The goal of the Rise Lab is to align patient values with medical decisions to produce goal-concordant care and to reduce the psychological burden of surrogate decision making. Our work is the source of the frequently cited statistic that “one in five Americans will die with ICU services.” We have focused both on refining measures of hospital end-of-life treatment intensity and exploring the mechanisms underlying variations in these measures using mixed qualitative and quantitative approaches, including participant observation, simulation, and mental-models interviewing. This research has led to a conceptual model regarding the interplay among provider social norms, patient and family expectations, and physician decision making heuristics,, which Dr. Barnato summarized in a recent invited overview in Health Affairs.