Providing adequate hospital care to patients from ethnic minority groups is challenging. We expect that delivering care in a multi-ethnic context can become even more difficult in critical medical situations in hospital, i.e. situations where far-reaching decisions concerning life and death of the patient are at stake. Because values and preferences concerning life and death are very closely related to ethno-cultural background, we hypothesize that this background could also play an important role in critical medical situations. However, until now long term in-depth empirical research about the actual practice of communication and decision making in multi-ethnic critical medical situations in hospital has been lacking. Additionally, few concrete recommendations to facilitate communication and decision making in such a setting exist. This dissertation tries to fill this knowledge gap by adressing following aims. The first and second aim is to explore in depth the general process of communication and decision making (aim 1) as well as end-of-life decision making (aim 2) between patients from ethnic minority groups, their relatives and healthcare professionals in critical medical situations in hospital. The third aim is to develop recomendations to facilitate communication and decision making between patients from ethno-cultural minority groups, their family members and healthcare professionals in critical medical situations in hospital. To achieve these research aims, two studies were done. The first study was a long-term ethnographic fieldwork study in an intensive care unit of a multi-ethnic hospital in Belgium, consisting of observations on the ward, interviews and document analysis. The second study was a survey research among intercultural mediators working in hospitals in Brussels and Flanders.