Experts warn of increasing overmedicalisation of death and urge a radical societal rethink
Globally, health and social systems fail to provide adequate, compassionate care for dying people and their families. Millions of people suffer needlessly due to the current emphasis on aggressive treatments to prolong life, global disparities in palliative care access, and high costs of end-of-life care. The Commission recommends a compassionate community model where communities and families collaborate with health and social services for the dying. As a result of the COVID-19 pandemic, many people have died alone, only communicating with their families via digital means.
During the last 60 years, health systems have taken over responsibility for dying. Most end-of-life care is provided in hospitals in the UK. Healthcare has alienated families and communities. People rely on health systems more because of this loss. Despite this, discussions about death and dying are often complex and stressful.
The Commission sets out five principles of a new vision for death and dying:
1. To live healthier lives and die more equitable deaths, we must address the social determinants of death, dying, and grief.
2. Relationships based on connection and compassion are prioritised and made central to the care and support of people dying or grieving.
3. Professionals must be included in networks of care for the dying, caring, and grieving.
4. Conversations and stories about everyday death, dying, and grief can help spark larger public debates and actions.
5. Death must be recognised as having value. "Without death, every birth would be a tragedy."
To achieve the widespread changes needed, the Commission sets out key recommendations for policymakers, health and social care systems, civil society, and communities, which include:
- Education on death, dying, and end-of-life care should be essential for people at the end of life, their families, and health and social care professionals.
- Increasing access to pain relief at the end of life must be a global priority, and the management of suffering should sit alongside the extension of life as a research and health care priority.
- Conversations and stories about everyday death, dying, and grief must be encouraged.
- Networks of care must lead support for people dying, caring, and grieving.
- Patients and their families should be provided with clear information about the uncertainties as well as the potential benefits, risks, and harms of interventions in potentially life-limiting illnesses to enable more informed decisions.
- Governments should create and promote policies to support informal carers and paid compassionate, or bereavement leave in all countries.
Source: The Lancet
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