Lancet Commission on the Value of Death (2)

9 February, 2022

Dear Neil,

Thank you for sharing this very apt Report from The Lancet Commission about Death, coming at a time when the World has seen so many deaths in the last two years, since the COVID-19 Pandemic started that there is the danger of mismanaging such an important and unavoidable event for all mankind, due to inurement and a sense of death fatigue.

Only a few days ago, I was in discussion with my physician daughter and we wondered how, and if, the tragic deaths of the millions of people during the pandemic, especially at the peak in 2020, were medically certified, in different parts of the World?. That is if certification of death even happened in all cases?.

I was attracted to read the Report on reading that Richard Smith, the respected, former Editor of The BMJ chaired the Lancet Commission, because my understanding and interest in the concept of ‘Good Death’ came from his Editorial on that topic in April, 2000, stressing that, that is ‘An important aim for health services and for us all' (Editorials: A good death. BMJ 2000;320:129). Then in 2003, sociologist, Tony Walter, in the same BMJ, wrote about the 'historical and cultural variants on good death', saying that what constitutes a good death has changed in the present globalized World, where it is now dominated by medicine compared to the past when religion was pre-eminent in that consideration. (‘Historical and cultural variants on the good death: BMJ 2003;327:218’).

It is important to note that the conclusion of The Lancet commission aligns with what present day Palliative care specialists, like John Ellershaw, et. al. said in their publication in BMJ in September, 2010, which is that, '‘a good death for all is now recognised as a priority at societal and political levels. To achieve this goal we need a fundamental shift of emphasis: to train and educate healthcare professionals, to ensure rigorous assessment of new end of life care services that aim to improve quality and choice, and to explore best use of resources'' (Achieving a good death for all: BMJ 2010;341:c4861).

Which means that the debate about what a good death means has gone full cycle, from society and religious dominance to individualism, and rightly, now to medicine, and therefore, it behoves every physician and health worker to work towards achieving a good death for all, especially as it is inevitable for all.

Joseph Ana.

Prof Joseph Ana

Lead Senior Fellow/ medical consultant.

Africa Center for Clinical Governance Research &

Patient Safety (ACCGR&PS)

P: +234 (0) 8063600642

E: info@hri-global.org

8 Amaku Street, State Housing & 20 Eta Agbor Road,

Calabar, Nigeria.

www.hri-global.org

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria, established by HRI Global (former HRIWA). In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: www.hri-global.org. Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.

Website: www.hri-global.com Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.

http://www.hifa.org/support/members/joseph-0

http://www.hifa.org/people/steering-group

Email: info@hri-global.org and jneana@yahoo.co.uk