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'Quality of Death' Needs Attention in Asia: Report

by Rathi Manohar on July 15, 2010 at 4:57 PM
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'Quality of Death' Needs Attention in Asia: Report

Asian countries, a study states, need to pay more attention to providing care for the dying, in view of the fact that living standards have improved a lot in the region.

As the global population ages, the demand for end-of-life care is expected to surge, and governments and other providers are racing against time to meet these needs, a report by the Economist Intelligence Unit (EIU) said.


Even economic powerhouse Japan was just 23rd among 40 countries ranked worldwide in a "quality of death" index, according to the study commissioned by the Lien Foundation, a Singapore philanthropic organisation.

India scored worst in the index at number 40, with China, Malaysia and South Korea also in the bottom 10 of the global list, which measures the care that dying people receive.

Uganda, Brazil, Mexico, Russia, Turkey, Portugal and South Africa were also among those which ranked poorly.

Britain topped the list for the best end-of-life care, followed by Australia, New Zealand, Ireland, Austria, the Netherlands, Germany, Canada and the United States.

Taiwan was at number 14 and Singapore was in 18th place.

"'Quality of life' is a common phrase.... But 'quality of death' is another matter," the study said.

"Few nations, including rich ones with cutting-edge healthcare systems, incorporate palliative care strategies into their overall healthcare policy."

This situation has prevailed "despite the fact that in many of these countries increasing longevity and ageing populations mean demand for end-of-life care is likely to rise sharply," it added.

According to the study, institutions specialising in palliative and end-of-life care "are not part of the national heathcare systems" and the availability of pain-killing drugs is "woefully inadequate across much of the world".

This is mainly due to concerns about the drugs' illicit use and trafficking, and there is also a lack of training among medical personnel on how to administer them.

"The result of this state of affairs is an incalculable surfeit of suffering, not just for those about to die but also for their loved ones," it said.

Another challenge is overcoming perceptions of death and cultural taboos about dying in order to improve palliative care.

By 2030, the number of people aged 65 and older is expected to reach one billion, or one in eight of the global population at that time, with the rise even sharper in developing countries, it said.

Falling birth rates, especially in developed countries, are likely to complicate the situation and for the first time in history, the number of people over 65 will outnumber children under five years old, it added.

While people are living longer, longevity also comes with more complex ageing diseases that are more expensive to manage, the study said, noting that people are now living with heart disease instead of dying of a coronary attack.

"For the end-of-life care community, this presents a new and complex set of problems," the report said.

It cited data showing that more than 100 million patients and their family care-givers need palliative support annually, but fewer than eight per cent of them actually receive it.

"Governments and providers are in a race against time," said the study, warning that spread of ageing was rapidly outpacing efforts to provide much-needed care.

"So while calls echo around the world for end-of-life care to become enshrined in national and international policy as a human right, the reality is that -- even if it achieves that status -- for much of the world's population, such a commitment will exist on paper only," it said.

Source: AFP


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