In their lead essay, the authors implored the medical profession to talk openly and frankly with Canadians about end-of-life care. Several months later much has changed, including an overwhelming vote by the membership at the annual general meeting of the Canadian Medical Association to let doctors follow their conscience in offering medical aid in dying. At the same time, we desperately need to improve and extend palliative care services and to embrace the concept of patient-centred care in end-of-life treatment. That includes encouraging patients to complete advance care plans and to discuss their wishes with family and friends because patient-centred care is about responsibilities and choices.