Surgeons might experience regret after interventions for high-risk patients who have poor outcomes, even when no errors occurred. Some regret experiences stem from incomplete communications or miscommunications about options, expectations, or prognoses. Experiences of regret, and even moral distress, might be mitigated when surgeons share key surgical care decisions with patients or their surrogates and draw on strategies for communicating well about patients' serious illnesses or injuries. Shared decision-making is a communication framework whose principles may contribute to mitigation of surgeon regret.