End-of-life care needs decolonising

Abstract

Rich knowledge and practices of community and family based care for dying people in formerly colonised countries should inform a reimagination of palliative care globally, say Christian R Ntizimira and colleagues End-of-life care existed long before modern medical practice. The perspectives of formerly colonised countries can help to create more inclusive and culturally sensitive end-of-life care worldwide that respects diverse attitudes to death and dying. Traditional end-of-life approaches in many communities include practices for spiritual, emotional, and physical healing—in South Africa, for example, traditional healers with a deep understanding of local customs and beliefs provide psychological, cultural, and spiritual care.1 From the mid-20th century, however, Cecily Saunders’s approach to palliative care quickly came to dominate international discourse.23 The imposition of Eurocentric models of palliative care in formerly colonised countries has marginalised local cultural values and practices related to dying, death, grieving, and community, with adverse results: international standards in palliative care fail to incorporate the values and needs of patients and families in diverse cultural settings, perpetuating social injustice.4 Pain management guidelines, for example, often prioritise pharmacological solutions over traditional …