A recent post on the Wall Street Journal’s Health Blog by Katherine Hobson brought to light a fascinating new study on the Quality of Death around the world. The Singapore-based philanthropic Lien Foundation commissioned the Economist Intelligence Unit to study forty countries in depth to gauge how much suffering accompanies the final few months of life. Researchers interviewed doctors and experts on palliative care to help measure four sub-indices: 1) basic end-of-life healthcare environment; 2) availability of end-of-life care; 3) cost of end-of-life care and 4) quality of end-of-life care. The results and rankings are shown below.
Predictably, most of the richer nations scored relatively well. But the biggest findings do not seem to be driven so much by a nation’s GNP as by the “culture of curing” and the scarcity of painkilling drugs. The study notes that medical professionals are trained to implement curative rather than palliative strategies–so much so that of the 100 million people worldwide who could benefit from palliative care annually, only 8% receive it. Likewise, regulations to stop illicit use of opiates often make them unavailable for clinical use. The result is that availability of painkilling drugs is “woefully inadequate” all around the world. Taken together, the authors conclude, these issues cause an “incalculable surfeit of suffering” for patients and their loved ones.
Still, in relative terms, you are much better off in the U.K. and Australia than China, Brazil or India when your candle is burning low. Once we all admit that death is a part of life, we can begin to appreciate the importance of the availability of quality palliative care and unflinchingly incorporate quality of death into our happiness index.