Into the sunset: End-of-life care

The Economist: Into the sunset: End-of-life care

The idea that the terminally ill need pain relief and humane care instead of “curing” is catching on. But what about the people who just grow old?

“MOST things may never happen: this one will.” That stark allusion to death, penned by the poet Philip Larkin, sums up the philosophical starting-point of the hospice movement, which began in Britain 40 years ago and has since become influential, in various ways, in almost every corner of the world. Given that your time on earth is bound to finish one day, assuring a decent quality of life in the final months and years often makes better sense than trying to prolong a painful existence for a short period; so in many cases, loving care and pain relief should take priority over aggressive intervention. When Dame Cicely Saunders, who founded the Saint Christopher’s Hospice in London in 1967, first aired those ideas, the medical world was hostile. Now her beliefs enjoy wide acceptance.

One sign of that change is the establishment of thousands of hospices, places dedicated to caring rather than curing. Another is the way in which doctors, nurses and patients in many other institutions have absorbed the movement’s thinking.

America’s first hospice was founded in 1974, and the idea spread rapidly. Half of all Americans will now use hospice care at some point in their lives, and around 75% of deaths in American hospitals occur after an explicit decision not to intervene….