This qualitative study examined how sign language interpreters make decisions regarding whether to accept or decline an interpreting assignment. This ethical decision holds the potential for a successful or unsuccessful interpreted interaction which can harm deaf consumers. This study is the first to examine this topic. Thus, the Literature Review included indirect research which described the complexities of making the decision to accept or decline assignments in today's interpreting business milieu. Semi-structured interviews were conducted with ten (10) sign language interpreter participants. Participants were recruited from the National Registry of Interpreters for the Deaf (RID) public database of certified interpreters. A general qualitative approach was applied to analyze the data and identify themes. Three major themes emerged from the data: Interpreter Referral Agencies, The Complexity of Decision-Making, and The Impact of Decision-Making on Deaf Consumers. The findings play a critical important role in, both understanding the current challenges in improving the quality of matches between deaf consumers and interpreters, as well as encourage opportunities for additional research on this topic. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]