In a previously published multicenter, prospective, randomized, controlled trial of more than 500 intensive care unit patients involved in conflicts over treatment decisions, ethics consultations were found to be helpful in resolving the conflicts and reducing nonbeneficial treatments. The intervention received favorable reviews by 80% of patient surrogates and more than 90% of physicians and nurses. Nevertheless, several participants in the ethics consultation process expressed dissatisfactions with the intervention. In this paper, we report our efforts to determine the factors associated with these negative responses in hopes that we might provide insights of future use to ethics consultants.We gratefully acknowledge the contributions of Jeffrey Blustein, Kathleen B. Briggs, Ronald Cranford, Glen I. Komatsu, and Ernle W.D. Young to the original randomized controlled trial phase of this research. Grant support came from the Agency for Healthcare Research and Quality, 1 R01 HS10251.