The emergence of the speciality of palliative medicine in the UK has been generally welcomed and can be seen as a continuation of the attempts to improve the care of dying people begun by the modern hospice movement. However, not everyone has welcomed the new speciality unreservedly. In part, this reflects a more general ambivalence and concern about the role of medicine in terminal care. After a brief discussion of the 'medicalization' of death and an overview of the hospital care of dying people, the paper identifies five concerns about the development of the speciality of palliative medicine in Britain. These are: the lack of clarity about its remit; a potential shift of focus away from terminal care; the inappropriate use of medical technology; the role of other health workers; the consequences for hospice care.