{"id":31736,"date":"2014-06-09T10:20:41","date_gmt":"2014-06-09T09:20:41","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=31736"},"modified":"2014-06-09T10:20:41","modified_gmt":"2014-06-09T09:20:41","slug":"the-bmj-today-dying-to-talk-about-it-care-and-conversations-near-the-end-of-life","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2014\/06\/09\/the-bmj-today-dying-to-talk-about-it-care-and-conversations-near-the-end-of-life\/","title":{"rendered":"The BMJ Today: Dying to talk about it\u2014care and conversations near the end of life"},"content":{"rendered":"<p>Why do we find it so difficult to talk about dying? A question that palliative care specialists, <a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g3699\">such as Scott Murray\u00a0and\u00a0Kirsty Boyd<\/a>, have been asking ever more urgently as populations age and the need for a good death (after a healthy life) moves higher up the healthcare agenda. It\u2019s not hard to find evidence of the problem: partners not discussing each other\u2019s preferences for care at the end of life, doctors not discussing the same with patients, everyone failing to record their own wishes for future reference, and patients with life limiting illnesses still dying a medicalised death in hospital as a result.<\/p>\n<p>Public awareness campaigns may help to encourage these difficult conversations at home and in clinics, surgeries, and hospital wards. But health professionals need specific training too, Murray and Boyd write, offering a helpful box of opening questions to get us started.<!--more--><\/p>\n<p>While dying well is everyone\u2019s business, most of us look to palliative care services to help achieve it. Traditionally based in hospitals and hospices, these services are shifting their focus to people\u2019s homes, where they control symptoms, coordinate care, and improve the quality of the final days and weeks of life.<\/p>\n<p><a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g3496\">A new study from Canada <\/a>suggests that community based services can also keep people out of hospital during their final illness, and help them die at home. This matters to patients and their families, but it also matters to providers, commissioners, and funders of health services, <a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g3693\">writes Fliss Murtagh<\/a> in her linked Editorial. Could specialist palliative care services based in the community improve the universal experience of dying, and relieve pressure on hospitals at the same time? It looks very much like it, she concludes.<\/p>\n<p>Elsewhere, <em>The BMJ<\/em> is keeping up the pressure on the European Medicines Agency (EMA) to rethink controversial plans, which restrict public access to important clinical trial data about drugs. In <a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g3768\">an open letter to Guido Rasi<\/a>, the regulator\u2019s director, leading voices from the All Trials campaign urge the EMA to lift the new restrictions or \u201crisk losing the trust of patients and healthcare professionals.\u201d The EMA meets to discuss \u201ctransparency\u201d proposals on 12 June.<\/p>\n<p>Read what all this has to do with the Protestant Reformation in 16th century Europe <a href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/06\/06\/richard-lehman-the-medical-reformation\/?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+bmj%2Fblogs+%28Latest+BMJ+blogs%29&amp;g=widget_default\">in a blog<\/a> by one of the letter\u2019s signatories. Richard Lehman has a warning for today\u2019s medical reformers campaigning for open data and \u201cdependable, real time, patient relevant evidence, which is brought to bear through effective shared decision making.\u201d Stick together, he writes, and do not squabble or things could get very messy indeed.<\/p>\n<p><em><strong>Alison Tonks<\/strong>\u00a0is an associate editor, The BMJ.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Why do we find it so difficult to talk about dying? A question that palliative care specialists, such as Scott Murray\u00a0and\u00a0Kirsty Boyd, have been asking ever more urgently as populations [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/06\/09\/the-bmj-today-dying-to-talk-about-it-care-and-conversations-near-the-end-of-life\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5750],"tags":[],"class_list":["post-31736","post","type-post","status-publish","format-standard","hentry","category-the-bmj-today"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The BMJ Today: Dying to talk about it\u2014care and conversations near the end of life - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/06\/09\/the-bmj-today-dying-to-talk-about-it-care-and-conversations-near-the-end-of-life\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The BMJ Today: Dying to talk about it\u2014care and conversations near the end of life - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Why do we find it so difficult to talk about dying? 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