In 20 years, yearly deaths will up from 58 million to 74 million globally. Many of these humans pass on quite alone, feel alienated, in pain and pride crushed unable to cope. Published in BMJ.com today is a special palliative care segment, experts suggest that society in general and its outlook towards dying, death and dealing with mortality need to change if we are to help ease the trauma of dying in others.

In a review of palliative care, a topic that was top of the list of items BMJ readers wanted to learn more about, several articles have been published that take the time to examine how learnings from end of life experiences in cancer patients can be implemented in persons near death related to cardiac arrest and dementia. Also these findings aid loved ones coping with the inevitable. The ultimate goal is to have doctors concentrate on providing the best end of life care possible to patients. In spring 2011, the BMJ Group launches a new journal in this field: BMJ Palliative and Supportive Care.

Palliative care (from Latin palliare, to cloak) is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than striving to halt, delay, or reverse progression of the disease itself or provide a cure. The goal is to prevent and relieve suffering and to improve quality of life for people facing serious, complex illness.

In the first of the above mentioned articles, Scott Murray and Kirsty Boyd observe that it is important for physicians to be accurate and swift in a death diagnosis. In the United Kingdom at least, they feel education and training are key factors.

In support of further education and mandatory training, Professor John Ellershaw states:

We must strive to ensure that a good death is the expectation rather than the exception in all settings.

General Practitioner Stephen Barclay and oncologist Jane Maher believe that clinicians need to facilitate an open and constant line of communication between themselves and patients. As this is obviously a tough subject for anyone to concentrate on when near death, heath care professionals need to create opportunities for patients to talk about end of life care, while respecting the wishes of those who prefer to not want discuss these matters.

They conclude:

The right conversations with the right people at the right time can enable patients and their loved ones to make the best use of the time that is left and prepare for what lies ahead.

In addition, and speaking to the importance of communication, Professor Jane Seymour and colleagues state:

Eradicating ignorance among clinicians, patients, and the public about what can be achieved with modern palliative care and encouraging dialogue about end of life care issues are important means of changing attitudes.

Professor Aziz Sheikh and colleagues at the University of Edinburgh emphasizes the importance of taking cultural rational into consideration when catering to not only the medical, but spiritual needs of dying persons. They conclude:

(Healthcare workers) need to be aware of their role in listening to patients, their careers and families, and others in the wider healthcare system with knowledge and understanding of the nuances of religious and cultural traditions.

Recognising and managing key transitions in end of life care
Kirsty Boyd, Scott A Murray

Having the difficult conversations about the end of life
Stephen Barclay, Jane Maher

BMJ (Published 16 September 2010)

Written by: Sy Kraft, B.A. – Journalism – California State University, Northridge (CSUN)