Below are the citation and selected extract of a Comment on the Lancet Commission, by HIFA Steering Group member Liz Grant (Director, Global Health Academy, University of Edinburgh) and Farzana Khan (Fasiuddin Khan Research Foundation, Bangladesh)
CITATION: The precariousness of balancing life and death
Liz Grant, Farzana Khan
The Lancet
Published: January 31, 2022
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00162-3/fulltext
'Diminishing the inevitability and humanity of death has obscured our understanding of health and life...
'Advances in technologies, science, medicine, artificial intelligence, and pharmaceuticals have saved lives but have complicated death in high-resourced health systems. Many people today die after substantial efforts at what is often called futile care. Such overtreatment in hospitals, mostly serving those with higher socioeconomic status, contrasts with a great global abyss of undertreatment. From the perspectives of those living in countries without adequate health resources, dying is too often characterised by gross inequity in access to basic care or support.
'In so many societies we have lost trust in, and relegated, our ability to deal with death. The medicalisation of death and the capability or otherwise of a health system to manage death has come to determine the way that death is treated. The Commission argues that only by re-establishing the value of death will we be able to transform our health systems. The Commission offers a vision of a new system for death and dying underpinned by five principles—tackling the social determinants of death, dying, and grieving; seeing death as a relational and spiritual process; enabling networks of informal and formal care; normalising conversations and stories of death, dying, and grief; and recognising death has a value. This framing points to ways to improve the experience of death and dying globally. Achievement of the Commission's vision will require a renewed belief in a shared humanity and the recognition that we are born equal, but into very unequal circumstances, and although we cannot change the inevitability of death, societies can change the circumstances to avert preventable deaths and provide the time, space, comfort, and compassion to die.'
Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org
