This article explores communicative practices surrounding how nurses, patients and family members engage when talking about death and dying, based on study conducted in a province in northern Thailand. Data were collected from three environments: a district hospital (nine cases), district public health centres (four cases), and in patients'homes (27 cases). Fourteen nurses, 40patients and 24 family members gave written consent for participation. Direct observation and indepth interviews were used for supplementary data collection, and 40 counselling sessions were recorded on video. The raw data were analysed using Conversation Analysis. The study found that Thai counselling is asymmetrical. Nurses initiated the topic of death by referring to the death of a third person a dead patient with the use of clues and via listconstruction. As most Thai people are oriented toBuddhism, religious support is selected for discussing this sensitive topic, and nurses also use Buddhism and listconstruction to help their clients confront uncertain futures. However, Buddhism is not brought into discussion on its own, but combined with other techniques such as the use of euphemisms or concern and care for others.