Spotlight Spotlight: Palliative Care Beyond Cancer

Dying matters: let’s talk about it

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c4860 (Published 16 September 2010) Cite this as: BMJ 2010;341:c4860
  1. Jane E Seymour, Sue Ryder Care professor of palliative and end of life studies1,
  2. Jeff French, professor of social marketing and chief executive2,
  3. Eve Richardson, chief executive 3
  1. 1School of Nursing, Midwifery, and Physiotherapy, University of Nottingham, Nottingham NG7 2HA
  2. 2Strategic Social Marketing, Liphook, Guildford GU30 7QW
  3. 3National Council for Palliative Care, London N7 9AS
  1. Correspondence to: jane.seymour{at}nottingham.ac.uk
  • Accepted 15 May 2010

As death has become less common in our daily lives, it has become harder to consider our own mortality or that of those close to us. Lack of openness about death has negative consequences for the quality of care provided to the dying and bereaved. Eradicating ignorance about what can be achieved with modern palliative care and encouraging dialogue about end of life care issues are important means of changing attitudes.

Awareness of our own mortality is a human characteristic. Arguably, life would have little meaning without our knowledge and experience of inevitable loss, death, and bereavement. But while in some ways our society is obsessed with death—with reports of violent, sudden, and unexpected death paraded across our media every day—it is still very difficult to talk about this one shared certainty in terms that relate to our own deaths or those of people close to us. Across the past century there has been a movement away from using the “sacred canopy” of religion1 to make sense of death and to embrace its presence in life. Instead, the defence of health, youth, and vigour against the enemy of death has become a “lifelong labour”2 for many. On the rare occasions when death and dying are discussed, the language used is most often rooted in the discourse of individualism and control of personal destiny. This perspective does not fit well with the needs and daily experiences of people approaching the end of life, such as those in advanced old age, who may find they wish or need to entrust their care to others. Nor does it reflect the finely balanced dilemmas patients, families, and clinicians face in dealing with the physical, ethical, emotional, and existential problems of serious illness. The increasingly rare designation of any illness as terminal complicates …

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