Aim:To compare the attitudes of health and social care professionals towards death and dying of people with intellectual and developmental disabilities (IDD)across countries. Method: Focus groups were held with medical, nursing and social care professionals in the UK (n=25), Portugal (n=15) and Nigeria (n=8).Results:In the UK, palliative care was reported to being consistent; few participants received relevant training and people with IDD were felt to be marginalised from decisions about their end of life care. Staff were concerned about assessment and management of symptoms. In Portugal there was generally little understanding of palliative care and limited discussion regarding death and dying with patients and families;relatives often having unrealistic expectations of treatment. People with IDD were mainly cared for within institutions; home care was not always successful.In Nigeria people with IDD were viewed as "different"and "difficult to handle" and there were few resources to help in their care. Conclusions: Profound differences in attitudes to palliative care needs of people with IDD exist reflecting societal taboos. Local developments are hindered by deeper cultural attitudes regarding the discussion of diagnosis and care indifferent countries.