A CONSULTATION process linked to the Forum on End of Life in Ireland has received significant public attention. One piquant reason is that dying and death affect us all. About 30,000 people die in Ireland annually, many of them in unhappy circumstances, away from their homes, or in crowded, grubby or noisy wards. What to do about this and related issues is one task of the forum, a project of the Irish Hospice Foundation.
Already in its workshops, public meetings and submissions, considerable material has been gathered on what people believe are the main issues at end of life. The process has been considerably enhanced by the perspectives of illness groups, statutory agencies, gays and lesbians, nursing and medical agencies, children’s groups, as well as bereavement and suicide experts. The views of older people, religious and spiritual groups, carers, architects and marginalised groups, and the pending presentations from nursing home interests, emergency services, educationalists, patients and family groups, as well as legal and human rights experts will also ensure rich material for public debate.
Arising from the forum, it is intended that action be taken on the substantial issues early next year. One of these is expected to be communications surrounding death. There is a failure on the part of many people, as well as Government and organisations, to engage with death issues. There is a gathering, though incomplete, view of what is meant by a “good death”. There is a general reluctance to plan for death and insufficient discussion on advanced care directives.
Significantly, there has been tardiness in acting on the evidence that most people want to die at home rather than in hospital. There can be scant satisfaction, too, with the level of public understanding about pain control and the benefits of a palliative-care approach to dying. Expectant mothers are advised about giving birth, adolescents about their sexual development, couples are enjoined to do pre-marriage courses. But death education is rare.
This is why the visit of Prof Allan Kellehear to Dublin next Wednesday evening is welcome. Kellehear, who is from the Centre for Death and Society at Bath University in England, will address the subject of death and death education in contemporary society. He will outline why it is important for the public to think of end of life, and the challenges for public policy. Vitally, he will tease out how we deal with the tension between the desire for quality and quantity of life.