For most of the twentieth century, a doctor would not openly disclose that you were dying. In Britain and the US, medical practitioners typically shielded patients from the full implications of the terminal conditions they observed through medical technologies. Why did doctors – and the relatives of dying patients – not discuss death openly? Why did this state of affairs change by the close of the century? This paper examines the arguments and impacts of the “death awareness movement” – an association of activists and experts that included psychiatrists, hospital and community doctors, nurses, social workers, sociologists, anthropologists, historians, and others – who lobbied for reform on these issues. The paper interrogates their cultural assumptions, personal experiences, and engagement with the shifting landscape of medical care in the twentieth century.