The technological

progress of medicine is medicalizing the death more and more, and the gap between the “good” and the actual death has been widening during the last decades[3,4]. Medicine did not deal with dying and death until the birth – some 50 years ago – of the hospice movement, which has the paramount merit of having focused the need of caring for dying persons in order to provide them the best quality of life achievable in their conditions. Actually, the aim of the hospice movement, explicitly or implicitly expressed by its Inhibitors,research,lifescience,medical leading persons, is letting terminal patients die better [5,6]. The praxis of palliative medicine, the discipline originated from hospice movement, grounded on scientific approach and rational methods, mainly consists in comprehensive treatments of pain and physical symptoms, in caring for the patient’s and their family’s needs, and in helping them to face anguish and solitude [7]. Palliative interventions are Inhibitors,research,lifescience,medical quite effective on physical suffering. Nevertheless, being free from physical symptoms, even if an important aspect of palliative care practice, is not always enough: psychological, social, emotional and spiritual suffering ought to be also controlled Inhibitors,research,lifescience,medical [8]. The non-physical suffering, however, is a much more individual and private matter, and refers to the individual’s biography, psychology,

beliefs, expectations and cultural mind-set [9,10]. Treating mental and spiritual anguish

with the same approach of body problems does not seem that effective and correct, and for some persons, a good death is sometimes missed [11-13]. It seems that an explicit model of best palliative care practice, accepted by all – at least in western Countries – actually does Inhibitors,research,lifescience,medical not exist, but the palliative care literature converges Inhibitors,research,lifescience,medical towards some specific aspects that contribute to define a death as a good one: symptom control, careful consideration for the social and relational context, preparation to die, and existential wellbeing [14,15]. Thus, care must be centred on the patient’s wishes and choices [16-18]: palliative care is, in fact, based on autonomy. A model of best practice in palliative care should be flexible and discussable, and, specially, manifold. It is hardly maintainable that a unique model can be used in a world all of moral and cultural strangers [19-21] given that what makes death “good” is different for everyone. In reality, inside hospice check details movement and palliative care, there are no official statements which state and describe that model. It is, however, probable that the practice of palliative care is actually grounded on a implicit model. Recently, the category of “good death” as an outcome of palliative medicine has been broadly discussed [7,22-31]. Furthermore the hospice movement has a strong stand against euthanasia and assisted suicide [32-34].