The ReSPECT ('Recommended Summary Plan for Emergency Care and Treatment') process was developed in the UK to guide and document conversations and decision-making with patients and their relatives around intervention during critical deterioration. This includes advising whether resuscitation should be attempted when a person dies. Current medical preparation for death is qualitatively different to social behaviours by people in the past and presents some controversies when considering the legal status of death-related decisions. In this article, we discuss our interdisciplinary perspectives as archaeological, historical, legal, medical and clinical psychologist academics following a historico-medico-legal appraisal of the ReSPECT process as situated in the current UK legal and cultural landscape. We review controversies and conundrums, and contextualise and contrast the current position to preparing for death and dying in the past.