This is the first comprehensive, evidence-based clinical guideline on managing depression in palliative care. The multinational nature of our expert group meant that the guideline incorporated the knowledge, expertise and experi ence of experts from 10 European countries. Regional varia tions in policy and patient care were identified within the expert group and these were debated to determine best practice. However, guideline development was led by a UK research group and as a consequence British clinicians were over-represented in the expert group. Health care organisa tion and models of ative care vary considerably across Europe and there are also important differences in public and professional perceptions, terminology and treatments 96 It is possible that the guideline content reflects the British