The most important recent advance has been the focus on the quality of care at the end of life and how to improve it. Although the most frequently cited studies on end-of-life care published since 1998 deal with euthanasia and assisted suicide, the concerns of dying patients include the quality of end-of-life care, achieving a sense of control, and strengthening relationships with loved ones. Improvements in end-of-life care can occur at the clinical, organisational and health system levels. The Physician Education in End-of-Life Care project is an ambitious effort to provide ongoing education to US physicians. The innovation here is to shift the focus from training palliative care specialists (an important undertaking in itself) to developing the clinical skills of all physicians who care for dying patients on a daily basis.
