EDITOR, - It is disappointing that Mina Mills and colleagues make no comment in their paper on the care of dying patients in hospital about changes that may have led to improvements in the past decade.1 Their study showed a lack of nursing care for dying patients, but whether this poor standard of care was applied to all patients admitted to hospitals in the study is not clear. For example, what was the standard of care for patients with stroke or other chronic disability? A similar study performed 10 years after the original would have been useful in showing any improvements or otherwise in practice. Nursing care may still be a problem, but perhaps this reflects general attitudes and staffing levels rather than a specific failure to address the needs of dying patients.