Dr Matthew Doré – Palliative Care Consultant

Northern Ireland Hospice & Belfast Trust
Hon Sec of APM and Co-lead Clin ECHO

I am blessed to have my parents and my wife’s parents all coming around for Christmas this year, and in the flurry of Christmas preparation it got me thinking. But, and with a big apology, please give me some morbid latitude as a palliative care doctor to be thinking about ONS mortality data.

If you look at the UK Office for National Statistics (ONS) data (2020-2022), the annual risk of death for a 70-year-old is approximately:

• 1.65% for males (probability of death, P_m = 0.0165)
• 1.18% for females (probability of death, P_f = 0.0118)

I have both mum and dad and mum-in-law and dad-in-law coming around for Christmas. Thus the probability that each survives the year:

• Male: 1 – P_m = 0.9835
• Female: 1 – P_f  = 0.9882

Probability that all four survive:

(0.9835)²×(0.9882)² = 0.96727225 × 0.97653924 ≈ 0.9446 (or 94.46%)

Probability that at least one dies and this is the last Christmas with all four:

1 – 0.9446 = 0.0554 (or 5.54%) This is a 1 in 18 event.

This calculation is not a cause for gloom, but for focus. It is a statistical nudge to fully appreciate the fleeting, precious chaos of this year’s gathering. The gentle arguments over board games, my dad’s dubious jokes, the mum’s steadfast over-catering – these are not trivialities but precious. They are the stuff of life, set against a clock whose ticking grows incrementally louder with each passing year.

So, this holiday, I prescribe for myself, and would recommend to all who are fortunate enough to have older loved ones around their table, a dose of mindful appreciation. Let the knowledge of life’s finitude be the reason you listen more closely to the familiar story, laugh more freely at the terrible cracker jokes, and hug a little tighter – yes, even your in-laws.

It is, statistically speaking, the least we can do.

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: None.