In their paper in this issue of the BJGP, Meeussen et al1 report that GPs knew the preferred place of death for 46% of their patients with non-sudden deaths. This information came from the patient alone for 40%, from significant others alone for 36% and from both for 22%. Patients whose GP knew their preferences were more likely to achieve their wish, and GP knowledge was associated with greater GP involvement in end-of-life care. The authors call for improvement in GPs' knowledge of patients' preferences for place of death, suggesting this to be a marker of end-of-life care quality.
The majority of terminally ill patients prefer to die at home; a preference that declines as illness progresses.2,3 However, such a preference is neither categorical nor fixed, but ‘a socially contingent leaning in a particular direction, rather than an abstractly arrived at certainty’ qualified by speculation about how things might change with events.4 A recent paper in the BMJ5 found preferences for place of …