Objectives: This paper describes the development and findings for a policy brief on “Advancing the Integration of Palliative Care into the National Health System” and the subsequent use of this report.

Methods: Key stakeholders involved with palliative care helped identify the problem and potential policy solutions to scale up these services within the health system. A working group of national stakeholder representatives and external reviewers commented on and contributed to successive drafts of the report. Research describing the problem, policy options and implementation considerations was identified by reviewing government documents, routinely collected data, electronic literature searches, contact with key informants, and reviewing the reference lists of relevant documents that were retrieved.

Results: The palliative burden is not only high but increasing due to the rise in population and life expectancy. A few options for holistic, supportive care include: Home-based care increases chances of a peaceful death for the terminally ill surrounded by their loved ones; supporting informal caregivers improves their quality of life and discharge planning reduces unscheduled admissions and has the potential to free up capacity for acute care services. A combination of strategies is needed to effectively implement the proposed options as discussed further in this article.

Conclusions: The policy brief report was used as a background document for two stakeholder dialogues whose main outcome was that a comprehensive national palliative care policy should be instituted to include all the options, which need to be integrated within the public health system. A draft policy is now in process.

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Objective: Optimal clinical practice depends upon a precise language with common understanding of core terms. The aim of the present study was to examine how Norwegian physicians understand the commonly used but poorly defined term “terminal.”

Methods: A questionnaire was mailed to 1605 Norwegian physicians, representative of the Norwegian medical community. Nine hundred and sixty-eight responded and defined “terminal” in expected weeks left to live. The effects of gender, age, specialty, and experience with prognostication toward end of life on the estimation of “terminal” were investigated.

Results: Norwegian physicians on average expect a “terminal” patient to have 3.6 (± 3.5 SD) weeks to live with expectation ranging from 0 to 26 weeks. The majority (83.5%) defined “terminal” as less than 5 weeks' survival; 15.0% as 5 to 12 weeks' survival and 1.5% as more than 12 weeks' survival. No difference between genders was observed, whereas the youngest physicians (27–39 years) held shorter definitions than the other age groups. Physicians in internal medicine, surgery, and anaesthesiology held significantly shorter estimations of “terminal” than did physicians in general practice, public health, and psychiatry.

Significance of results: Our study shows that the majority of Norwegian physicians restrict “terminal” to the last 2–4 weeks of patients' lives. A life expectancy of a few days compared to several weeks should lead to different clinical actions. Efforts should therefore be made to come to a common definition of the term. In our opinion the use of “terminal” should be limited to when death is expected within a few days.