Dying has become over medicalised and “invisible” – and care systems need to switch to reducing unnecessary suffering, an international panel of experts says today.
The pandemic has accelerated the trend – with dying patients placed in expensive ventilators and separated from their families, according to the latest Lancet expert commission.
Society now gives priority to avoiding death rather than reducing unnecessary suffering – and this contributes to too many people dying a bad death, according to the experts.
The Commission involved social scientists, patient activists and theologians as well as doctors.
It points to a social movement in Kerala, India, where in the last 30 years tens of thousands of volunteers have “reclaimed” death as a social concern and responsibility.
The co-chair Dr Libby Sallnow, a palliative medicine consultant based at University College London, said: “How people die has changed dramatically over the past 60 years, from a family event with occasional medical support, to a medical event with limited family support. A fundamental rethink is needed in how we care for the dying, our expectations around death, and the changes required in society to rebalance our relationship with death.
“The COVID-19 pandemic has seen many people die the ultimate medicalised death, often alone but for masked staff in hospitals and intensive care units, unable to communicate with their families, except digitally.”
Dr Richard Smith, another co-chair, said: “Dying is part of life, but has become invisible, and anxiety about death and dying appears to have increased. Our current systems have increased both undertreatment and overtreatment at the end of life, reduced dignity, increased suffering and enabled a poor use of resources.
“Healthcare services have become the custodians of death, and a fundamental rebalance in society is needed to re-imagine our relationship with death.”
Dr M.R. Rajagopal, from Pallium India, one of the contributors, said: “Caring for the dying really involves infusing meaning into the time left. It is a time for achieving physical comfort; for coming to acceptance and making peace with oneself; for many hugs; for repairing broken bridges of relationships and for building new ones. It is a time for giving love and receiving love, with dignity. Respectful palliative care facilitates this. But it can be achieved only with broad-based community awareness and action to change the status quo.”
Lancet 1 February 2022
Leave a Reply