"What is your understanding of your father's illness?" This is the kind of question that may be posed by emergency clinicians in the context of end-of-life care. But as a survey of Thai and American emergency departments finds, approaches to these conversations can be quite different globally. This episode also features another angle on end-of-life care, highlighting the persistent impact that deprivation has when it comes to likelihood of hospital conveyance. On a different subject, there is a qualitative study of the management of acute asthma presentations, seeking to find any marginal gains that may present a chance for optimisation. The fourth and final paper is about acute coronary syndromes in the emergency department, presenting some surprising statistics on length of stay. Read the highlights: September 2025 primary survey Deprivation is associated with hospital conveyance among patients who are terminally ill Are acute asthma presentations to the emergency department an opportunity for optimising long-term management? A qualitative study on beliefs and behaviours of healthcare professionals Comparing approaches to code status conversations between Thai and American emergency clinicians: a survey study Acute coronary syndrome rule-out strategies in the emergency department: an observational evaluation of clinical effectiveness and current UK practice The EMJ podcast is hosted by: Prof. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)Dr. Sarah Edwards, EMJ Senior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast Apple (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.