Facing death differently: revolutionising our approach to death and grief

Abstract

Despite growing public interest in death, support for end-of-life care and bereavement remains inadequate. We urgently need a community centred, public health approach to the social processes of dying and grieving, backed by properly funded palliative care, writes Lucy Selman Over 600 000 people die each year in the UK,1 leaving more than six million grieving.2 On the surface, attitudes to death seem to be shifting: witness the rise of death and grief cafés,3 festivals and annual awareness events,4567891011 and the formation, in 2018, of a national association of end-of-life doulas.12 Television shows, films, and books about dying and grieving proliferate. A BBC video by the palliative care doctor, author, and activist Kathryn Mannix, “Dying is Not as Bad as You Think,” has had 145 000 views.13 But beneath the surface are major gaps in public knowledge and confidence around death, meaning that the practical, emotional, and spiritual wishes of dying people often remain unexpressed and unfulfilled. Meanwhile, futile medical interventions at the end of life persist as a global failure.14 Death is as natural a process as birth, yet much of society refuses to see it that way. This discomfort shows in our behaviour: we avoid seriously ill or bereaved people, and we shy away from discussing our own end-of-life wishes with family, friends, and health professionals. These attitudes are deeply intertwined with cultural and systemic issues, from harmful misconceptions about grief to the medicalisation of dying. Recent debates on assisted dying have put an intense spotlight on the failures of our attitudes towards, and systems for, end-of-life care and bereavement support, and the MP Rachael Maskell has announced a commission to improve palliative care. It’s a timely and vital move, but the commission must tackle the …