OBJECTIVE: Cultural differences in willingness to discuss death may influence participation rates, accuracy of responses and cross-cultural comparability in health valuation studies. We therefore characterized perceptions and comfort in discussing death in a multi-ethnic, urban Asian population. METHODS: In in-depth interviews with adult Chinese and Indian Singaporeans (selected to represent various ages/ educational levels) conducted in English, Chinese or Tamil, subjects rated their ease in discussing death (EID) using a 0-10 visual analogue scale (VAS). Subjects also reported, using the same scale: 1) religiosity; 2) acceptability of 8 descriptors for death (e.g. passed away, sudden death, immediate death); and 3) preference for “pits” versus “all-worst”. Finally, subjects valued 3 hypothetical health states using 0-100 VAS followed by time trade-off (TTO). The influences of various factors on EID were compared using Mann-Whitney tests. Correlations between EID and health utilities were evaluated using Spearman rank correlation. RESULTS: Among 46 subjects (54% Chinese, 54% female, median age: 42 years), median self-reported religiosity was significantly lower for Chinese (5.0 (0.0, 7.0)) compared to Indians (7.0 (5.0, 10.0), p=0.004). Subjects were generally comfortable in discussing death (median (IQR): 8.0 (7.0 to 10.0)). Neither sociodemographic factors nor religiosity influenced subjects' comfort level. In relation to descriptors for death, both Chinese and Indian subjects felt “passed away” (median (IQR): 8.0 (7.0, 10.0)) was more acceptable than “sudden death” (5.0 (3.0, 7.0)) or “immediate death” (5.0 (2.0, 7.0)). Subjects clearly preferred “all-worst” (median (IQR): 8.0 (6.0, 9.3)) to “pits” (5.0 (0.8, 8.0)). Correlations between EID and health utility score were generally weak (range –0.263 to 0.386 (VAS) and –0.283 to 0.162 (TTO)). CONCLUSIONS: Chinese and Indian Singaporeans were generally comfortable in discussing death. The poor correlation between EID and health utility scores suggests that the latter are unlikely to be influenced by willingness to discuss death.