For nuclear utilities to become competitive in a deregulated electricity market, costs must be reduced, safety must be maintained, and interested stakeholders must remain content with the decisions being made. One way to reduce costs is to reduce the frequency of preventive maintenance and testing. However, these changes must be weighed against their impact on safety and stakeholder relations. We present a methodology that allows the evaluation of decision options using a number of objectives that include safety, economics, and stakeholder relations. First, the candidate decision options are screened to make sure that they satisfy the relevant regulatory requirements. The remaining options are evaluated using multiattribute utility theory. The results of the formal analysis include a ranking of the options according to their desirability as well as the major reasons that explain this ranking. These results are submitted to a deliberative process in which the decision makers scrutinize the results to ensure that they are meaningful. During the deliberation, new decision options may be formulated based on the insights that the formal analysis provides, as happened in the case study of this paper. This case study deals with the reduction in frequency of the containment integrated leak rate test of a boiling water reactor.