The Quality of Death: Ranking End-of-Life Care Across the World

by Sarah Murray

Jul 12, 2010
As the proportion of the world's population grows disproportionately older, the need for end-of-life services will only increase. This paper ranks 40 countries in terms of the quality and availability of end-of-life care. For this paper, the author also conducted in-depth interviews with over 20 experts on the subject from across the world -- including palliative care specialists, physicians, healthcare economists and sociologists -- and reviewed existing research on the topic.
  • The UK leads the world in quality of death, based on indicators such as public awareness, training availability, access to pain killers and doctor patient transparency, and has led the way in terms of its hospice care network and statutory involvement in end-of-life care.
  • Combating perceptions of death, and cultural taboos is crucial to improving palliative care. In Western societies, death has become medicalized and curative procedures are often prioritized ahead of palliative care.
  • Pain control is the point from which all palliative care stems, and the availability of opioids is fundamental to end-of-life care, however an estimated 5 billion peoplearound the world lack access to opioids, principally due to concerns about illicit drug use and trafficking.
  • State funding of end-of-life care is limited and often prioritizes conventional treatment. In many countries, end-of-life care bodies rely on charitable donations and philanthropic activity to support them.
  • In the US, while palliative care is available through public medical insurance, patients must relinquish curative treatments to be eligible for reimbursements.
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