Around 500 000 people die in England each year, and this number is predicted to rise to around 530 000 by 2030. Death affects every person, family, and community, and every culture and creed has its own way of dealing with it. We should all have an interest in good end of life care, yet death is not culturally acceptable, and it is a taboo subject to the public and the medical profession. In a recent BBC survey, only 34% of the general public reported that they had discussed their wishes for how they would like to die. Many healthcare professionals consider it a failure when patients die. In April 2008, the Heath Commission reported that no less than 54% of complaints related in some way to end of life care.

Last week the Department of Health published its strategy for dealing with end of life care in the United Kingdom.1 Producing such a strategy is challenging because it incorporates health care, social care, spiritual care, and all possible sensitivities, as well as homeless people, prisoners, and mentally disabled people. More than 300 stakeholders were consulted. We need …