The Lancet Commission urges rebalance to End of Life conversations

“The most beautiful funeral I’ve ever been to. Such a reflection of the person,” Rani Foreman, Death Doula, says of her Father’s funeral on the Coffs Coast.


A NEW Lancet Commission calls for public attitudes to death and dying to be rebalanced, away from a narrow, medicalised approach towards a compassionate community model, where communities and families work with health and social care services to care for people dying.

Bringing together experts in health and social care, social science, economics, philosophy, political science, theology, community work, as well as patient and community activists, the Commission has analysed how societies around the world perceive death and care for people dying, providing recommendations to policy makers, governments, civil society, and health and social care systems.

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Dr Libby Sallnow, a palliative medicine consultant and honorary senior clinical lecturer at St Christopher’s Hospice and UCL (UK) and co-Chair of the Commission said, “How people die has changed dramatically over the past 60 years, from a family event with occasional medical support, to a medical event with limited family support.

“To achieve the widespread changes needed, the Commission sets out key recommendations for policy makers, health and social care systems, civil society, and communities.”

The recommendations include:

1: Education on death, dying, and end of life care should be essential for people at the end of life, their families and health and social care professionals.

2: Increasing access to pain relief at the end of life must be a global priority, and the management of suffering should sit alongside the extension of life as a research and health care priority.

3: Conversations and stories about everyday death, dying, and grief must be encouraged.

4: Networks of care must lead support for people dying, caring, and grieving.

5: Patients and their families should be provided with clear information about the uncertainties as well as the potential benefits, risks, and harms of interventions in potentially life-limiting illness to enable more informed decisions.

6: Governments should create and promote policies to support informal carers and paid compassionate or bereavement leave in all countries.

Coffs Harbour based End of Life Doula Rani Foreman shared her views with News Of The Area, “I couldn’t agree more with the aims of the Commission and input from Dr Libby Sallnow.

“It’s heartening to read.

“The only additional comment I would make is regarding point 1.

“It states ‘Education on death, dying and end of life care should be essential for people at the end of (their) life…”

“I agree, but I truly believe we need to take this one step further and be having conversations about death and dying, breaking down the taboo now while people are healthy and well, not just at the end of life.

“As an End Of Life Doula I currently do this through what’s called Death Cafe gatherings, Death Over Dinner events and online programs to have these taboo conversations now.”

For info on the Commission see




The Lancet Commission calls for a compassionate community model to care for people dying.

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