Anticipating, recognising and talking about dying: Can we close the gap?

There is a culture of avoidance of discussion of dying in hospital-based NHS healthcare. The disinclination to name, recognise or talk about the possibility of dying among senior staff, and lack of modelling of clear yet compassionate conversations about dying with dying people, communicates a ‘hidden curriculum’ of the low value of this essential component of practice. It results in late recognition of dying, lost opportunities for dying people to reorder their priorities, late referrals for palliative care support, and missed chances to improve quality of life at an earlier stage. It is time to address medical reluctance to view the last stage of life as a precious, unique time that deserves scrupulous attention to what matters most to the sick person; to demedicalise dying; and to work to restore public (and professional) understanding of ‘ordinary dying’.