“Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs. The hard question we face, then, is not how we can afford this system’s expense. It is how we can build a healthcare system that will . . . help dying patients achieve what’s most important to them at the end of their lives.”
I came across this paragraph in an article titled “Letting Go” in the 2 August issue of the New Yorker. The author of the article is Atul Gawande, a working surgeon and associate professor at Harvard Medical School. He is a soldier in the healthcare trenches, who also happens to be a fine essayist.
Dying is not a pleasant subject, but it is one that healthcare stakeholders must confront, and not simply from the perspective of prolonging life at any cost. Remarkable advances in healthcare over the past few decades have us living longer and more healthily than previous generations could have imagined. Our quality of life has improved immeasurably. But what about our quality of death?
A white paper recently published by the Economist Intelligence Unit ranked the quality of end-of-life care in countries across the world. The paper, which was commissioned by the Lien Foundation, a Singapore-based philanthropic organisation, found that the United Kingdom had the most enlightened end-of-life policies in place, (despite the fact that its healthcare system as a whole did not even crack the top 20). The United Kingdom scored especially well in such categories as public awareness, training availability, access to pain killers and doctor-patient transparency. Interestingly, a country’s GDP or the quality of its overall healthcare structure did not necessarily have a positive effect on its ranking. France, which has one of the best healthcare systems in the world according to the World Health Organization (and my personal experience), ranked 12th in the quality of death index, for example.
It’s a fascinating study. You can read more about it and access the white paper at our blog: www.medtechinsider.com/archives/15964.
A question for you: as a member of the medical device industry, do you agree with Gawande that our technology-based healthcare system fails to meet the most basic needs of patients nearing the end of life? Post your comments in the online version of this editorial.