Over the last three decades, safety-critical industries (e.g. Nuclear, Aviation) have witnessed an evolution from risk-based to risk-informed safety management approaches, in which quantitative risk assessment is only one component of the decision making process. While the oil and gas pipeline industry has recently made several advancements towards safety management processes, their safety performance may still be seen to fall below the expected level achieved by other safety-critical industries. The intent of this paper is to focus on the safety decision making process within pipeline integrity management systems. Pipeline integrity rules, routines, and procedures are commonly based on regulatory requirements, industry best practices, and engineering experience; where they form "programmed" decisions. Non-programmed safety and business decisions are unique and "usually" unstructured, where solutions are worked out as problems arise. Non-programmed decision making requires more activities towards defining decision alternatives and mutual adjustment by stakeholders in order to reach an optimal decision. Theoretically, operators are expected to be at a maturity level where programmed decisions are ready for most, if not all, of their operational problems. However, such expectations might only cover certain types of threats and integrity situations. Herein, a formal framework for non-programmed integrity decisions is introduced. Two common decision making frameworks; namely, risk-based and risk-informed are briefly discussed. In addition, the paper reviews the recent advances in nuclear industry in terms of decision making, introduces a combined technical and management decision making process called integrity risk-informed decision making (IRIDM), and presents a guideline for making integrity decisions.