Death as a Global Public Health Issue

This article was exclusively written for The European Sting by Ms. Daniele Gameiro Mansano, a 5th year medical student at the Faculty of Medicine of Marília (FAMEMA), Brazil. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

            Dying is a natural process, inherent to the condition of being human. However, health services, in general, are not prepared to deal with this fact. And in a world hit by a new disease pandemic, talking about how people are dying must be a priority. Since dying is a natural process, health managers, physicians, nurses and the entire health team are expected to be prepared to deal with it, ensuring a dignified death for each citizen, understanding, beyond their pathological processes, but also social, psychological, spiritual ones and many others that accompany the patient on his deathbed.

            For this to happen, beyond profound cultural changes that must occur in every society, it’s even more urgently an investment in the education of students and health professionals towards this complex theme. Palliative Care should be seen as a specialty, but it should also be understood as an essential study for every health professional. Knowing Palliative Care is of paramount importance in order to obtain comprehensive care for patients, from the moment they receive a diagnosis with a difficult prognosis, until their last moments of life and, in addition to them, understanding that their family and friends will be directly involved in this illness process.

            Technological advances did not include the necessary advances in the area of Palliative Care and, as a result, it is observed that 86% of people who need such care do not receive it and 83% of patients do not have access to pain relief in this process¹. These numbers reinforce the urgent need to rethink health education globally, restructuring academics’ curricula and working on continuing education for trained health professionals.

            According to the WHPCA Global Atlas of Palliative Care², the biggest obstacles to the implementation of Palliative Care in a comprehensive way, worldwide, are due to a small number of public health policies that support, to an education of health professionals that does not address death as a process in the life of a patient, few medications available for symptoms to be managed, bringing relief and comfort, the need to implement existing public policies, even if incipient and difficulty in looking at specific population groups, in order to fully and equitably meet each population group, considering their particularities, in addition to the need to break socio-cultural barriers for the implementation of such changes.

            It is through integral health and consistent public policies that concrete changes can be implemented in the way people die in the world, aiming for relief and comfort and, above all, specialized monitoring for patients with no prognosis of cure at all times.

References:

1. WORD HEALTH ORGANIZATION. WHA67.19: Strengthening of palliative care as a component of comprehensive care throughout the life course. Genebra: Who, 2014. Avaiable: https://apps.who.int/gb/ebwha/pdf_files/wha67/a67_r19-en.pdf. Access : 14 dez. 2020.

2. Connor, Stephen. (2020). Global Atlas of Palliative Care 2nd Edition Global Atlas of Palliative Care at the End of Life Global Atlas of Palliative Care 2nd Edition Acknowledgements and Authorship Contributing writers: Acknowledgements.

About the author

Daniele Gameiro Mansano is a 5th year medical student at the Faculty of Medicine of Marília (FAMEMA) and a member of the International Federation of Medical Students Associations of Brazil (IFMSA Brazil), a national member organization of IFMSA, and the foundress of the interdisciplinary academic league research in palliative care at FAMEMA.