Attitudes must change if we are to achieve a good death for all, say experts

September 17, 2010

Society's attitudes towards dying, death and bereavement need to change if we are to achieve a good death for all, say experts in a special series of articles published in the British Medical Journal today in the first BMJ "Spotlight" supplement.

By 2030 the annual number of deaths around the world is expected to rise from 58 million to 74 million, but too many people still die alone, in pain, without dignity, or feeling alienated.

The articles aim to remedy this by exploring how lessons learnt from end of life care for cancer patients can be adapted for those dying from like and dementia.

"Palliative care beyond cancer" also topped a recent BMJ poll of topics respondents wanted to read more about, suggesting that doctors are keen to be more open about death and deliver better end of life care for their patients.

In the first article, Scott Murray and Kirsty Boyd say that the ability to make an accurate and timely diagnosis of dying is "a core clinical skill that could be done better in all care settings." They believe that education and training of staff are central to the success of end of life policies in the UK.

The need for mandatory training is supported by Professor John Ellershaw and colleagues who argue that to achieve a good death for all "we need a fundamental shift of emphasis." They say "we must strive to ensure that a good death is the expectation rather than the exception in all settings."

In another article about having the difficult conversations about the end of life, GP Stephen Barclay and oncologist Jane Maher believe that clinicians need to create repeated opportunities for patients to talk about their future and end of life care, while respecting the wishes of those who do not want to discuss such matters. "The right conversations with the right people at the right time can enable patients and their loved ones to make the best use of the time that is left and prepare for what lies ahead," they write.

Talking about dying is also the subject of an article by Professor Jane Seymour and colleagues. They say: "Eradicating ignorance among clinicians, patients, and the public about what can be achieved with modern and encouraging dialogue about end of life care issues are important means of changing attitudes."

Finally, Professor Aziz Sheikh and colleagues at the University of Edinburgh explore how the spiritual needs of dying patients can be understood and met in pluralist and secular societies. They believe healthcare workers "need to be aware of their role in listening to patients, their carers and families, and others in the wider healthcare system with knowledge and understanding of the nuances of religious and cultural traditions."

Explore further: End-stage dementia patients deserve the same access to palliative care as people with cancer

Related Stories

End-of-life care at hospitals varies for children with cancer

February 5, 2009

Though treatment of pain and attention to end-of-life care for pediatric cancer patients has improved over the last few decades, there is still work to be done. Additionally, opioid prescriptions for pediatric cancer patients ...

Recommended for you

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Machine Translates Thoughts into Speech in Real Time

December 21, 2009

( -- By implanting an electrode into the brain of a person with locked-in syndrome, scientists have demonstrated how to wirelessly transmit neural signals to a speech synthesizer. The "thought-to-speech" process ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.