When asked about a future figurehead in palliative care, Dame Cicely says that the patient is the figurehead, and must remain so. She also touches on the relationship between the ability to work in palliative care and the need of the religious faith, or at least a 'philosophy that underpins your life'. It is interesting to note that palliative care has become a global movement and our societies have become ever more multi-ethnic. Sharma's article on spiritual care for Hindu patients is therefore timely. Meaning at the end of life today can no longer be found only in the age old certainties of western Christianity, even though hospices arose from their medieval namesakes.
Popular movements are closely related to consumer power.
Palliative care is no exception. However, consumer power is so often driven by marketing imperatives rather than rational decisions. Somehow we need to harness the popularity of the palliative care movement to the rationality of our academics. Nauck and colleagues examine the problems of symptom control in the last three days of life. They conclude that detailed care and attention are essential, but also that we must design appropriate research to improve the help we offer our patients.