The goal of palliative medicine is to prevent and relieve suffering and to support the best quality of life for patients and their families, regardless of the stage of the disease or need for other therapies (1). Palliative care expands traditional disease model medical treatments to include the goals of enhancing quality of life, optimizing function, and helping with decision making, and unlike hospice it is delivered simultaneously with any appropriate life-prolonging treatments. The articles selected for this update were drawn from a keyword search followed by a review of more than 17 000 citations from 20 leading journals in general medicine, palliative medicine, anesthesia, oncology, nursing, and social work spanning September 2005 to June 2007. We rated a subset of these manuscripts on the basis of the quality of the science, innovativeness, and applicability to clinicians who practice palliative medicine. This last criterion applies not only to specialists in palliative medicine, but also to internists, family medicine clinicians, nurse practitioners, and subspecialists in internal medicine—all of whom care for patients with a wide range of advanced, chronic illnesses. We selected the articles ranked highest by these criteria, using a consensus process to resolve ratings discrepancies. The Table summarizes changes to clinical practice that should emerge from these articles.