Few countries provide a good place to die: Research
month ago, and you can find additional details on the website created by the Joint Palliative Care Center at Duke-NUS Medical School in Singapore.
“Society should also be judged on how much people die,” said Eric Finkelstein, a palliative care specialist and professor at Duke-NUS and the Duke Institute of Global Health in Durham, North Carolina.
“Many individuals in both the developed and developing worlds die tragically – not in a place of their choice, without dignity or compassion, with limited understanding of their illness, after spending all their savings, and often regret their course of treatment. These are very common.”
To compile the rankings, Finkelstein and colleagues surveyed more than 1,200 caregivers from several countries to determine what is most important to patients at the end of life. They then asked 181 palliative care professionals globally to classify their countries’ health systems based on the 13 key factors people most commonly list, including pain control and comfort. having the right roof, having a clean and safe space, being treated with kindness, and getting treatments that are relevant to quality of life, rather than just prolonging life.
The UK earned the top spot in the study, followed by Ireland, Taiwan, Australia, South Korea and Costa Rica, all of which earned an A. The US scored a C, placing 43 out of 81 countries. family.
At the bottom of the rankings are 20 countries that scored poorly, many of which are low- or middle-income countries with fewer health resources than the highest-ranked countries.
Richard Smith, a palliative care specialist and former editor of the British Medical Journal. He and Finkelstein also serve on the Lancet Commission on the Value of Death, a global panel of palliative care professionals who are expected to make recommendations to improve end-of-life care. later this year.
Stephen Connor, executive director of the Worldwide Hospice Palliative Care Alliance and one of the study’s colleagues, says it’s no coincidence that most of the survey’s top scorers are from wealthy nations. with a well-funded health system. -lecturers. “Demand for palliative care is huge in low- and middle-income countries, where less than a third of services exist,” he notes.
But Connor and Finkelstein both point to the average US rating as proof that money doesn’t always guarantee interest in hospice. In the US, he said, resources are often invested in end-of-life efforts, rather than in measures to ensure comfort and quality of life in a patient’s final days.
“We spend a lot of money trying to help people live longer, but we don’t spend enough money to help people,” says Finkelstein, who is also director of the Palliative Care Center at Duke-NUS. better die. The research was funded by the Lien Foundation, a non-profit organization based in Singapore that focuses on improving quality of life.
Finkelstein says: Heartbreaking stories of COVID-19 deaths, when healthcare workers are often the only ones allowed to comfort the dying, will bring new focus to care. end of life.
“Generally speaking, people don’t talk about death. COVID has made it less taboo. We have the opportunity to continue this discussion and not only help COVID patients, but everyone else with their experiences. better end-of-life experience,” he said.
Finkelstein and colleagues hope the national rankings spur action from policymakers to improve conditions for dying patients, such as easing restrictions on prescribed painkillers. offered to comfort those at the end of life.
But people don’t necessarily have to wait for policy changes to take steps to ensure a better end-of-life experience, Finkelstein said. He advises people of any age or health condition to make an end-of-life plan and discuss it with family and friends.
“Make an advanced care plan or at least express your wishes to friends and family,” he says. “Don’t wait. By the time you fall ill, it may be too late and people may not know what you want.”