AN INTERNATIONAL expert on death and dying has warned that, unless there is a major change of political attitude toward end-of-life care policy in the developed world “we will see a return to the widespread social neglect of the dying we first witnessed in our hospitals after [the second] World War”.
Prof Allan Kellehear, of the Centre for Death and Society at the University of Bath in England, was speaking in Dublin last night.
He delivered a lecture, Whose Death Is It Anyway?, at a public talk organised by the Forum on End of Life in Ireland.
“Dying as a deathbed experience . . . covers a minor, nay, tiny minority of those whose illness has privileged them with awareness and a timely referral to hospice.”
For most, however, “either we move suddenly into an acute care facility such as a hospital, where we may be subject to aggressive rescue missions by well-meaning medical and nursing professionals, or we gradually become confined by chronic illness, imprisoned first in our own homes, and then later in an aged care institution”.
It was then “little wonder the voluntary euthanasia societies remain popular with the elderly in particular”. The fact was “that the greatest age-related suicide rate is for those over the age of 80 years”. This was no coincidence.
“The longer we live, the more stretched become the limits to our financial resources, friendships, family networks and health. Few of us remain passive, resigned or philosophical when our autonomy is under threat. Yet without support, autonomy is not sustainable in the face of deteriorating health, social networks, or finances.”
For this reason “community development and health promotion at the end of life is crucial if we are to strengthen our chances against the erosion of our independence, and in also drawing practical lines against encroaching professional control at the end of life”, he said.
A broad public health approach which encouraged people to look after themselves and other people was required, he said.