THE IRISH Hospice Foundation's (IHF) championing of issues relating to dying, death and bereavement has gained further impetus with its decision to set up a forum on end-of-life care.
Through its Hospice Friendly Hospitals programme and other work, the IHF has done much to change Irish culture in regard to death. More than 40 hospital settings are striving to ensure that patients who die do so as painlessly as possible and in peaceful and dignified surroundings with their spiritual and emotional wishes addressed. And initial planning for the new forum bodes well in terms of advancing these objectives.
After its launch in January, it is intended that the forum will engage in extensive consultation with the public and diverse interest groups. An action plan will be devised and a national coalition will be set up to promote it. In this regard, it will be important that the initiative becomes more than a rolling debate. Much will depend on how it is chaired, organised and communicates its vision. Through discussion and study, the forum aims to sift the factors that make up a good death. It will examine all aspects of end-of-life care as well as provision for older people. Topically, the impact of traumatic death will be considered, including the needs of families and communities affected by suicide or murder. There will be a vital focus on how some media deal with end-of-life matters. Scrutiny can be expected also of the financial issues affecting carers as well as the need for regulation of funeral and embalming services.
Citizens will be encouraged to ask and to expect responses to many awkward questions. Among these will be the length of time it can take for a certificate on the cause of death to be issued and the preponderance of so much end-of-life care in hospitals rather than in the patient's home. The uneven distribution of hospice care throughout the State and the spiritual needs of dying people will be other issues. Responses to such questions will facilitate the development of a national consensus on dealing with dying and death - in line with the growing recognition that end-of-life care is not only a medical and religious concern but that it touches on public ethics.
It is clear that many people would favour a formal legal mechanism to record in advance their choices on care and treatment in the event of accident or illness. Choice is a key theme that should be highlighted in all aspects of end-of-life care. It is the least the 30,000 people who die each year deserve.