COVID-19 has shown us images of patients dying in isolation, apart from loved ones during their final moments. But even before the pandemic, harrowing deaths were all too common in most parts of the world, a new survey of end-of-life care shows. The study ranked 81 countries on how well their health systems provide for the physical and mental wellbeing of patients at the end of life. Only six countries earned an A grade.
The study, detailed in three papers to be published in the Journal of Pain and Symptom Management, ranked 81 countries on how well their health systems provide for the physical and mental wellbeing of patients at the end of life. Only six countries earned grades of A, while 36 earned Ds or Fs.
The survey results appeared in the Journal of Pain and Symptom Management last month, and additional details may be found on a website created by the Lien Centre for Palliative Care, part of the Duke-NUS Medical School in Singapore.
«Society should also be judged on how well people die,» says Eric Finkelstein, a palliative care expert and professor with Duke-NUS and the Duke Global Health Institute in Durham, North Carolina, who led the study. «Many individuals in both the developed and developing world die very badly — not at their place of choice, without dignity, or compassion, with a limited understanding about their illness, after spending down much of their savings, and often with regret about their course of treatment. These things are very common.»
To compile the rankings, Finkelstein and colleagues surveyed more than 1,200 caregivers from several countries to identify what is most important to patients at the end of life. They then asked 181 palliative care experts across the globe to grade their countries’ health systems on 13 weighted factors that people most often listed, including proper management of pain and comfort, having a clean and safe space, being treated kindly, and treatments that address quality of life, rather than merely extending life.
The United Kingdom earned the highest ranking in the study, followed by Ireland, Taiwan, Australia, South Korea and Costa Rica, which all earned A grades. The United States earned a C, ranking 43rd of the 81 countries.
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Materials provided by Duke University. Note: Content may be edited for style and length.