Context. A central approach of palliative care has been to provide holistic care for people who are dying, terminally ill, or facing life-limiting illnesses while neither hastening nor postponing death. Assisted dying laws allow eligible individuals to receive medically administered or self-administered medication from a health provider to end their life. The implementation of these laws in a growing number of jurisdictions therefore poses certain challenges for palliative care.Objectives. To analyze the research literature about the relationship of assisted dying with palliative care, in countries where it is lawful.Methods. A five-stage scoping review process was adapted from the Joanna Briggs Institute. Data sources searched through October 2018 were MEDLINE, CINAHL, PsychINFO, SCOPUS, and ProQuest dissertations and theses, with additional material identified through hand searching. Research studies of any design were included, but editorials or opinion articles were excluded.Results. After reviewing 5778 references from searches, 105 were subject to full-text review. About 16 studies were included: from Belgium (n ¼ 4), Canada (n ¼ 1), Switzerland (n ¼ 2), and the U.S. (n ¼ 9). We found that the relationship between assisted dying and palliative care practices in these locations took varied and sometimes combined forms: supportive, neutral, coexisting, not mutually exclusive, integrated, synergistic, cooperative, collaborative, opposed, ambivalent, and conflicted.Conclusion. The studies in this review cast only partial light on challenges faced by palliative care when assisted dying is legal. There is pressing need for more research on the involvement of palliative care in the developing practices of assisted dying, across a growing number of jurisdictions. J Pain Symptom Manage 2020;59:1287e1303. Ó

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New demographic and epidemiological trends mean people are dying at older ages and over long periods of time, from multiple, chronic illnesses. There is a perception that these growing and changing needs will require novel community responses. One starting point is having ‘conversations’ about dying and death, and in this the phenomenon of ‘Death Café’ merits attention. In the first study of its kind, we report on interviews with forty-nine Death Café organisers in thirty-four countries, exploring how this ‘cultural intervention’, first developed in the UK, has transferred elsewhere. Using thematic analysis, we identify competing tensions between: local translation of Death Café and a desire for international alignment alongside instrumental use of the Death Café form and its incidental effects. The passion and commitment of Death Café organisers is compelling but may not lead to the behavioural change required to support a new public face of dying.

Medicalisation is a pervasive feature of contemporary end of life and dying in Western Europe and North America. In this article, we focus on the relationship between two specific aspects of the medicalisation of dying: deep continuous palliative sedation until death and assisted dying. We draw upon a qualitative interview study with 29 health professionals from three jurisdictions where assisted dying is lawful: Flanders, Belgium; Oregon, USA; and Quebec, Canada. Our findings demonstrate that the relationship between palliative sedation and assisted dying is often perceived as fluid and complex. This is inconsistent with current laws as well as with ethical and clinical guidelines according to which the two are categorically distinct. The article contributes to the literature examining health professionals’ opinions and experiences. Moreover, our findings inform a discussion about emergent themes: suffering, timing, autonomy and control – which appear central in the wider discourse in which both palliative sedation and assisted dying are situated, and which in turn relate to the wider ideas about what constitutes a ‘good death’.