Spotlight Spotlight: Palliative Care Beyond Cancer

Achieving a good death for all

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c4861 (Published 16 September 2010) Cite this as: BMJ 2010;341:c4861
  1. John Ellershaw, professor of palliative medicine13,
  2. Steve Dewar, director of research and innovation2,
  3. Deborah Murphy, associate director13
  1. 1Marie Curie Palliative Care Institute, University of Liverpool, Liverpool L69 3BX
  2. 2Marie Curie Cancer Care, London SE1 7TP
  3. 3Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool L7 8XP
  1. Correspondence to: j.e.ellershaw{at}liv.ac.uk
  • Accepted 15 May 2010

A good death for all is now recognised as a priority at societal and political levels. To achieve this goal we need a fundamental shift of emphasis: to train and educate healthcare professionals, to ensure rigorous assessment of new end of life care services that aim to improve quality and choice, and to explore best use of resources.

“How people die remains in the memory of those who live on.”

Dame Cicely Saunders1

The importance of high quality care for patients in the final hours and days of life has received national recognition in recent years.2 3 Increasingly the need to establish this element of care in the core business of hospitals and other care settings is acknowledged. Providing high quality care for the dying is a marker of our commitment to the delivery of care to all. As Mike Richards, national clinical director for end of life care in the UK, remarked in the foreword of the first National Care of the Dying Audit of Hospitals in England in 2007,4 “How we care for the dying must surely be an indicator of how we care for all our sick and vulnerable patients.” The growing proportion of elderly people in the developed world will have consequences for the economies and healthcare systems of these countries. The elderly are “more likely to have highly complex problems and disabilities, and need packages of care that require partnership and collaboration between different groups and across many settings”.5 The number of deaths in England and Wales is set to increase by 17% between 2012 and 20306 and WHO5 suggests that provision of palliative care and, more specifically, services to deliver care for the dying, need to be enhanced and made available in all care settings to make this …

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