Currently, contemporary health care systems are poorly designed to meet their palliative care needs. As a consequence, many people with chronic illnesses either fall between the gaps or receive inappr...opriate or ineffective care. The delivery of sub-optimal care contributes to increased health care costs and causes unnecessary suffering, especially when clinically futile treatments are administered or symptoms are poorly managed. In addition, increasing access to care provides a conundrum in withdrawing and withholding treatment. This chapter explores a range of palliative care issues for people suffering from illnesses other than cancer and provides discussion of the implications for policy, practice and research.