Letters Place of death

It’s important to see death and dying in a broad cultural context

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5679 (Published 27 October 2015) Cite this as: BMJ 2015;351:h5679
  1. Richard Smith, free range sceptic1
  1. 1London SW4 0LD, UK
  1. richardswsmith{at}yahoo.co.uk

Pollock is right that place of death is a poor surrogate for the quality of dying,1 but in sniping at home as the best place to die she fails to see the broader cultural context.

One of her key messages is that “hospitals will remain the place where most people die,” but why?

Firstly, we need to demedicalise death, recognise its inevitability and normality. For 99% of human existence dying had little or nothing to do with doctors. Doctors have a role to play, but if deaths continue to occur in hospital then death will remain medicalised and the province of doctors.

Secondly, the whole trend in healthcare is to move it to the community rather than hospitals. Doctors who spend their life in hospitals forget what dangerous, horrible, frightening, uncomfortable places they are. Along with prisons, they are “total institutions,” where wanting to stay up late listening to Pink Floyd is seen as rebellion.

Notes

Cite this as: BMJ 2015;351:h5679

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