This is a qualitative study of eighteen Israeli health care social workers' experiences at times of end-of-life decisions in light of the 2007 law that legitimises patients' rights to withhold life-sustaining treatments under certain conditions. Results convey a troublesome picture in which social workers tend to remove themselves from involvement in these decisions due to an experience of inefficiency. The study reveals two main obstacles to involvement in end-of-life decisions: (i) fears about the well-being of the dying patient, his/her family members, their colleagues and themselves; and (ii) the impossible position of social workers due to conflicting demands between (a) perception of their role and expectations of the multidisciplinary team, (b) personal views and the patient's wishes, (c) personal views and professional norms, (d) organisational principles and the new law, and (iii) the patient's rights and the procedures required to implement them. Implications for social work education and socialisation, as well as the practice of health care social workers, are discussed.