Where is the best place to die?

A recent study of end-of-life care finds few countries do well in providing for patients in their final days.

“Society should also be judged on how well people die,” says Eric Finkelstein, a palliative care expert and professor with Duke-NUS and the Duke Global Health Institute in Durham, North Carolina, who led the study. “Many individuals in both the developed and developing world die very badly – not at their place of choice, without dignity, or compassion, with a limited understanding about their illness, after spending down much of their savings, and often with regret about their course of treatment. These things are very common.”

To compile the rankings, Finkelstein and colleagues surveyed more than 1,200 caregivers from several countries to identify what is most important to patients at the end of life. They then asked 181 palliative care experts across the globe to grade their countries’ health systems on 13 weighted factors that people most often listed, including proper management of pain and comfort, having a clean and safe space, being treated kindly, and treatments that address quality of life, rather than merely extending life.

The United Kingdom earned the highest ranking in the study, followed by Ireland, Taiwan, Australia, South Korea and Costa Rica, which all earned A grades. The United States earned a C, ranking 43rd of the 81 countries.

Read more and access survey report