Improving end-of-life communication, decision-making and care has been identified as a pressing health issue in Ontario (and in Canada more generally), as evidenced by recent research,(1;2) public opinion polls,(3) expert panels and commissions,(4-6) and a high-profile legal case,(7) which have revealed many challenges in this area. The importance of this issue is also reflected by a strong push from various organizations to support citizens in having informed conversations about end-oflife issues and engaging in formalized advance care planning,(8) large advocacy coalitions dedicated to quality end-of-life care,(9;10) numerous initiatives to support high-quality integrated palliative and end-of-life care, including implementation of the 2011 Declaration of Partnership and Commitment to Action,(11) as well as an active research community dedicated to this issue.