Method: The study was conducted with qualitative methodology by ten focus groups discussion with 104 participants include of physicians, nurses, religious leaders, educators, lawyers, journalists all over the country. In-depth- interviewed with key informants who took part of policy level about Thai context in palliative care. The data was analyzed by content analysis.

Results: It was found that the concept of palliative care has been applied in health care system in Thailand depend on users’ perception and understanding.  The situations of palliative care could be explained in 3 models of care which difference level; 1) the care which was not applied to full form, the health care providers have used as individual and case by case 2) the care which was developing and trying in to the units and wards, and 3) the care which used the concept of palliative care, holistic care and applied to units until after death. The third model has only in the tertiary care. In addition the key issues of care up to the way of thinking of people about death. Lack of deep understanding about perception, value, believe and socio-cultural context of death and dying so that patients and families could not meet the quality of care. Conclusion: This study enhance to understanding the key factors related to appropriate palliative care for Thai people, especially the paradigm of death and dying knowledge, the way to develop palliative care system, and also the guidance of research about death and dying for policy makers and stakeholders in the future.