The Lancet Commission on the Value of Death would like your help

7 October, 2019

Dear Friends,

I’m chairing the Lancet Commission on the Value of Death, and the Commission would be grateful for your help.

Our basic idea is that medicine has developed an unhealthy relationship with death (overtreating, seeing it as a failure, etc), and we want to try and create a healthier relationship.

We fear that in high income countries death has been transformed from a social and family event with medical input to a medical event with family and social input.

The unhealthy relationship with death is primarily a problem in high income countries, but the problem is spreading to low income countries, sometimes leading to families being bankrupted through excessive treatment at the end of life.

The Lancet has already published a Commission on Palliative Care, which made clear that most people in low and middle income countries do not have access to basic palliative care and opiates.

It may well be that treatment at the end of life - with excess in high income countries and almost nothing for most people in the world—is one of the most extreme inequalities in global health. And there is suffering caused by both excess and absence of treatment.

The Commission has a website that includes background papers, all of which are free to access.

We will particularly welcome comments on our emerging story, which will serve as the basis for our report.

Best wishes

Richard Smith

HIFA profile: Richard Smith is chair of the Lancet Commission on the Value of Death, the Point of Care Foundation (which works to make health care more humane), and Patients Know Best, a company that gives patients control of their health and social care records. He was previously editor of the BMJ and chief executive of the BMJ Publishing Group, chair of icddr,b (formerly International Centre for Diarrhoeal Disease Research, Bangladesh), and director of the UnitedHealth Chronic Disease Initiative, a programme with the National Heart, Lung, and Blood Institute to create centres in low and middle income countries to conduct research and build capacity in relation to NCD. He blogs regularly for the BMJ and on his own website (