People in countries including the UK may be overtreated as they die, making death less humane as the role of health care grows and that of families and communities diminishes, a commission says.
A Lancet Commission says an overemphasis on aggressive treatments to prolong life, global inequities in palliative care access, and high end-of-life medical costs have led to millions of people suffering unnecessarily.
The experts say many people, mainly in low and middle-income countries, have no access to palliative care, and particularly to opioids, while those in high-income countries may be overtreated.
Dignity, absence of pain, an element of control, easy access to family and friends, and good communication are all considered to be aspects of a good death.
But the commission is concerned that trying to define a good death may deteriorate to a box-ticking exercise, and says that people will have a different idea of what constitutes a good death just as they do a good life.
“The decision of when to accept death and stop treatment aimed at delaying death is difficult," said Dr Richard Smith, co-chair of the commission.
“Unfortunately, it is much easier to go on treating people than it is to have what has been called ‘the difficult conversation’.
“People are thus not aware of the benefits and risks of different options. There is lots of evidence these ‘difficult conversations’ don’t happen or happen too late.”
Over the past 60 years, dying has moved from the family and community setting to become primarily the concern of health systems, experts say.
In the UK, about one in five people require end-of-life care are at home, while about half are in hospital.
Global life expectancy has risen steadily from 66.8 years in 2000 to 73.4 years in 2019.
But as people are living longer, they are living more of these additional years in poor health.
“To die in pain without access to opioids is torture," Dr Smith said.
“Meanwhile, many people in high-income countries are overtreated at the end of life, often with futile treatments that bring no benefit to the dying person, which increases suffering.
“Many people die in acute hospitals, which are usually not good places to die.”
The experts say more attention should be paid to the dying, their families and communities, and the social and cultural aspects of death.
“We want to see a rebalancing with a bigger role for families and communities, and health professionals playing an important but supporting rather than leading role," Dr Smith said.
“When the NHS began, death was usually faster, happened at a younger age, and was less likely to occur in an institution, and doctors had much less capacity to delay death.
“As the world has changed, much more emphasis has been paid to the medical aspects of death and less to the family, community, cultural and social aspects.
“People have also become much less familiar with death. Deaths occur in institutions, and bodies are whisked away. Coffins are closed.
“The unfamiliarity with death has probably made people more scared of death. We would like to see many more stories and conversations about death and dying, and more familiarity with death and dying.
“We would like people to become ‘death literate’, familiar with the process and able to contribute to care. Most care for the dying is not complex.”
The commission, made up of experts from across a range of fields, including health and social care and patient and community activists, analysed how societies around the world perceive death and care for those dying.
“The Covid-19 pandemic has seen many people die the ultimate medicalised death, often alone but for masked staff in hospitals and intensive care units, unable to communicate with their families, except digitally," said Dr Libby Sallnow, palliative medicine consultant and UCL and co-chair of the commission.
“How people die has changed dramatically over the past 60 years, from a family event with occasional medical support, to a medical event with limited family support.”
The commission sets out key recommendations for policy makers, health and social care systems, civil society and communities.
Some of these include: education on death, dying, and end of life care; increasing access to pain relief at the end of life must be a global priority; conversations and stories about everyday death, dying and grief; and networks of care must lead support for people dying, caring, and grieving.
The commission also sets out five principles of a new vision for death and dying, including that dying must be understood to be a relational and spiritual process rather than simply a physiological event.
England's all-time record goalscorers:
Wayne Rooney 53
Bobby Charlton 49
Gary Lineker 48
Jimmy Greaves 44
Michael Owen 40
Tom Finney 30
Nat Lofthouse 30
Alan Shearer 30
Viv Woodward 29
Frank Lampard 29
Copa del Rey
Semi-final, first leg
Barcelona 1 (Malcom 57')
Real Madrid (Vazquez 6')
Second leg, February 27
Key facilities
- Olympic-size swimming pool with a split bulkhead for multi-use configurations, including water polo and 50m/25m training lanes
- Premier League-standard football pitch
- 400m Olympic running track
- NBA-spec basketball court with auditorium
- 600-seat auditorium
- Spaces for historical and cultural exploration
- An elevated football field that doubles as a helipad
- Specialist robotics and science laboratories
- AR and VR-enabled learning centres
- Disruption Lab and Research Centre for developing entrepreneurial skills
The specs: McLaren 600LT
Price, base: Dh914,000
Engine: 3.8-litre twin-turbo V8
Transmission: Seven-speed automatic
Power: 600hp @ 7,500rpm
Torque: 620Nm @ 5,500rpm
Fuel economy 12.2.L / 100km
Full list of brands available for Instagram Checkout
Adidas @adidaswomen
Anastasia Beverly Hills @anastasiabeverlyhills
Balmain @balmain
Burberry @burberry
ColourPop @colourpopcosmetics
Dior @dior
H&M @hm
Huda Beauty @hudabeautyshop
KKW @kkwbeauty
Kylie Cosmetics @kyliecosmetics
MAC Cosmetics @maccosmetics
Michael Kors @michaelkors
NARS @narsissist
Nike @niketraining & @nikewomen
NYX Cosmetics @nyxcosmetics
Oscar de la Renta @oscardelarenta
Ouai Hair @theouai
Outdoor Voices @outdoorvoices
Prada @prada
Revolve @revolve
Uniqlo @uniqlo
Warby Parker @warbyparker
Zara @zara
Safety 'top priority' for rival hyperloop company
The chief operating officer of Hyperloop Transportation Technologies, Andres de Leon, said his company's hyperloop technology is “ready” and safe.
He said the company prioritised safety throughout its development and, last year, Munich Re, one of the world's largest reinsurance companies, announced it was ready to insure their technology.
“Our levitation, propulsion, and vacuum technology have all been developed [...] over several decades and have been deployed and tested at full scale,” he said in a statement to The National.
“Only once the system has been certified and approved will it move people,” he said.
HyperloopTT has begun designing and engineering processes for its Abu Dhabi projects and hopes to break ground soon.
With no delivery date yet announced, Mr de Leon said timelines had to be considered carefully, as government approval, permits, and regulations could create necessary delays.
THE SPECS
Engine: 3.5-litre V6
Transmission: six-speed manual
Power: 325bhp
Torque: 370Nm
Speed: 0-100km/h 3.9 seconds
Price: Dh230,000
On sale: now
KILLING OF QASSEM SULEIMANI
Essentials
The flights
Whether you trek after mountain gorillas in Rwanda, Uganda or the Congo, the most convenient international airport is in Rwanda’s capital city, Kigali. There are direct flights from Dubai a couple of days a week with RwandAir. Otherwise, an indirect route is available via Nairobi with Kenya Airways. Flydubai flies to Kinshasa in the Democratic Republic of Congo, via Entebbe in Uganda. Expect to pay from US$350 (Dh1,286) return, including taxes.
The tours
Superb ape-watching tours that take in all three gorilla countries mentioned above are run by Natural World Safaris. In September, the company will be operating a unique Ugandan ape safari guided by well-known primatologist Ben Garrod.
In the Democratic Republic of Congo, local operator Kivu Travel can organise pretty much any kind of safari throughout the Virunga National Park and elsewhere in eastern Congo.
Best Foreign Language Film nominees
Capernaum (Lebanon)
Cold War (Poland)
Never Look Away (Germany)
Roma (Mexico)
Shoplifters (Japan)
The bio:
Favourite holiday destination: I really enjoyed Sri Lanka and Vietnam but my dream destination is the Maldives.
Favourite food: My mum’s Chinese cooking.
Favourite film: Robocop, followed by The Terminator.
Hobbies: Off-roading, scuba diving, playing squash and going to the gym.
Abu Dhabi Sustainability Week
Tips to avoid getting scammed
1) Beware of cheques presented late on Thursday
2) Visit an RTA centre to change registration only after receiving payment
3) Be aware of people asking to test drive the car alone
4) Try not to close the sale at night
5) Don't be rushed into a sale
6) Call 901 if you see any suspicious behaviour
Company Profile:
Name: The Protein Bakeshop
Date of start: 2013
Founders: Rashi Chowdhary and Saad Umerani
Based: Dubai
Size, number of employees: 12
Funding/investors: $400,000 (2018)
Fighting with My Family
Director: Stephen Merchant
Stars: Dwayne Johnson, Nick Frost, Lena Headey, Florence Pugh, Thomas Whilley, Tori Ellen Ross, Jack Lowden, Olivia Bernstone, Elroy Powell
Four stars
Have you been targeted?
Tuan Phan of SimplyFI.org lists five signs you have been mis-sold to:
1. Your pension fund has been placed inside an offshore insurance wrapper with a hefty upfront commission.
2. The money has been transferred into a structured note. These products have high upfront, recurring commission and should never be in a pension account.
3. You have also been sold investment funds with an upfront initial charge of around 5 per cent. ETFs, for example, have no upfront charges.
4. The adviser charges a 1 per cent charge for managing your assets. They are being paid for doing nothing. They have already claimed massive amounts in hidden upfront commission.
5. Total annual management cost for your pension account is 2 per cent or more, including platform, underlying fund and advice charges.
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The Great Derangement: Climate Change and the Unthinkable
Amitav Ghosh, University of Chicago Press
Our legal consultant
Name: Dr Hassan Mohsen Elhais
Position: legal consultant with Al Rowaad Advocates and Legal Consultants.
What is graphene?
Graphene is a single layer of carbon atoms arranged like honeycomb.
It was discovered in 2004, when Russian-born Manchester scientists Andrei Geim and Kostya Novoselov were "playing about" with sticky tape and graphite - the material used as "lead" in pencils.
Placing the tape on the graphite and peeling it, they managed to rip off thin flakes of carbon. In the beginning they got flakes consisting of many layers of graphene. But as they repeated the process many times, the flakes got thinner.
By separating the graphite fragments repeatedly, they managed to create flakes that were just one atom thick. Their experiment had led to graphene being isolated for the very first time.
At the time, many believed it was impossible for such thin crystalline materials to be stable. But examined under a microscope, the material remained stable, and when tested was found to have incredible properties.
It is many times times stronger than steel, yet incredibly lightweight and flexible. It is electrically and thermally conductive but also transparent. The world's first 2D material, it is one million times thinner than the diameter of a single human hair.
But the 'sticky tape' method would not work on an industrial scale. Since then, scientists have been working on manufacturing graphene, to make use of its incredible properties.
In 2010, Geim and Novoselov were awarded the Nobel Prize for Physics. Their discovery meant physicists could study a new class of two-dimensional materials with unique properties.
Our family matters legal consultant
Name: Hassan Mohsen Elhais
Position: legal consultant with Al Rowaad Advocates and Legal Consultants.
The%20Hunger%20Games%3A%20The%20Ballad%20of%20Songbirds%20%26%20Snakes
%3Cp%3E%3Cstrong%3EDirector%3A%3C%2Fstrong%3E%C2%A0Francis%20Lawrence%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3EStars%3A%C2%A0%3C%2Fstrong%3ERachel%20Zegler%2C%20Peter%20Dinklage%2C%20Viola%20Davis%2C%20Tom%20Blyth%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3ERating%3A%20%3C%2Fstrong%3E3%2F5%3C%2Fp%3E%0A
The line up
Friday: Giggs, Sho Madjozi and Masego
Saturday: Nas, Lion Bbae, Roxanne Shante and DaniLeigh
Sole DXB runs from December 6 to 8 at Dubai Design District. Weekend pass is Dh295 while a one day pass is Dh195. Tickets are available from www.soledxb.com
Diriyah%20project%20at%20a%20glance
%3Cp%3E-%20Diriyah%E2%80%99s%201.9km%20King%20Salman%20Boulevard%2C%20a%20Parisian%20Champs-Elysees-inspired%20avenue%2C%20is%20scheduled%20for%20completion%20in%202028%3Cbr%3E-%20The%20Royal%20Diriyah%20Opera%20House%20is%20expected%20to%20be%20completed%20in%20four%20years%3Cbr%3E-%20Diriyah%E2%80%99s%20first%20of%2042%20hotels%2C%20the%20Bab%20Samhan%20hotel%2C%20will%20open%20in%20the%20first%20quarter%20of%202024%3Cbr%3E-%20On%20completion%20in%202030%2C%20the%20Diriyah%20project%20is%20forecast%20to%20accommodate%20more%20than%20100%2C000%20people%3Cbr%3E-%20The%20%2463.2%20billion%20Diriyah%20project%20will%20contribute%20%247.2%20billion%20to%20the%20kingdom%E2%80%99s%20GDP%3Cbr%3E-%20It%20will%20create%20more%20than%20178%2C000%20jobs%20and%20aims%20to%20attract%20more%20than%2050%20million%20visits%20a%20year%3Cbr%3E-%20About%202%2C000%20people%20work%20for%20the%20Diriyah%20Company%2C%20with%20more%20than%2086%20per%20cent%20being%20Saudi%20citizens%3Cbr%3E%3C%2Fp%3E%0A
How do Sim card scams work?
Sim swap frauds are a form of identity theft.
They involve criminals conning mobile phone operators into issuing them with replacement Sim cards by claiming to be the victim, often pretending their phone has been lost or stolen in order to secure a new Sim.
They use the victim's personal details - obtained through criminal methods - to convince such companies of their identity.
The criminal can then access any online service that requires security codes to be sent to a user's mobile phone, such as banking services.
More from Neighbourhood Watch:
Five famous companies founded by teens
There are numerous success stories of teen businesses that were created in college dorm rooms and other modest circumstances. Below are some of the most recognisable names in the industry:
- Facebook: Mark Zuckerberg and his friends started Facebook when he was a 19-year-old Harvard undergraduate.
- Dell: When Michael Dell was an undergraduate student at Texas University in 1984, he started upgrading computers for profit. He starting working full-time on his business when he was 19. Eventually, his company became the Dell Computer Corporation and then Dell Inc.
- Subway: Fred DeLuca opened the first Subway restaurant when he was 17. In 1965, Mr DeLuca needed extra money for college, so he decided to open his own business. Peter Buck, a family friend, lent him $1,000 and together, they opened Pete’s Super Submarines. A few years later, the company was rebranded and called Subway.
- Mashable: In 2005, Pete Cashmore created Mashable in Scotland when he was a teenager. The site was then a technology blog. Over the next few decades, Mr Cashmore has turned Mashable into a global media company.
- Oculus VR: Palmer Luckey founded Oculus VR in June 2012, when he was 19. In August that year, Oculus launched its Kickstarter campaign and raised more than $1 million in three days. Facebook bought Oculus for $2 billion two years later.
COMPANY%20PROFILE
%3Cp%3E%3Cstrong%3EName%3A%20%3C%2Fstrong%3EQureos%0D%3Cbr%3E%3Cstrong%3EBased%3A%20%3C%2Fstrong%3EUAE%0D%3Cbr%3E%3Cstrong%3ELaunch%20year%3A%20%3C%2Fstrong%3E2021%0D%3Cbr%3E%3Cstrong%3ENumber%20of%20employees%3A%20%3C%2Fstrong%3E33%0D%3Cbr%3E%3Cstrong%3ESector%3A%20%3C%2Fstrong%3ESoftware%20and%20technology%0D%3Cbr%3E%3Cstrong%3EFunding%3A%20%3C%2Fstrong%3E%243%20million%0D%3Cbr%3E%3C%2Fp%3E%0A
Squads
Sri Lanka Tharanga (c), Mathews, Dickwella (wk), Gunathilaka, Mendis, Kapugedera, Siriwardana, Pushpakumara, Dananjaya, Sandakan, Perera, Hasaranga, Malinga, Chameera, Fernando.
India Kohli (c), Dhawan, Rohit, Rahul, Pandey, Rahane, Jadhav, Dhoni (wk), Pandya, Axar, Kuldeep, Chahal, Bumrah, Bhuvneshwar, Thakur.
F1 The Movie
Starring: Brad Pitt, Damson Idris, Kerry Condon, Javier Bardem
Director: Joseph Kosinski
Rating: 4/5
The specs
Engine: 2-litre 4-cylinder and 3.6-litre 6-cylinder
Power: 220 and 280 horsepower
Torque: 350 and 360Nm
Transmission: eight-speed automatic
Price: from Dh136,521 VAT and Dh166,464 VAT
On sale: now
FULL%20FIGHT%20CARD
%3Cp%3EFeatherweight%20Bout%3A%0D%20Abdullah%20Al%20Qahtani%20v%20Taha%20Bendaoud%0D%3Cbr%3EBantamweight%20Bout%3A%0D%20Ali%20Taleb%20v%20Nawras%20Abzakh%0D%3Cbr%3EBantamweight%20Bout%3A%0D%20Xavier%20Alaoui%20v%20Rachid%20El%20Hazoume%0D%3Cbr%3EFeatherweight%20Bout%3A%0D%20Islam%20Reda%20v%20Adam%20Meskini%0D%3Cbr%3EBantamweight%20Bout%3A%0D%20Tariq%20Ismail%20v%20Jalal%20Al%20Daaja%0D%3Cbr%3EBantamweight%20Bout%3A%0D%20Elias%20Boudegzdame%20v%20Hassan%20Mandour%0D%3Cbr%3EAmateur%20Female%20Atomweight%20Bout%3A%0D%20Hattan%20Al%20Saif%20v%20Nada%20Faheem%0D%3Cbr%3EFeatherweight%20Bout%3A%0D%20Maraoune%20Bellagouit%20v%20Motaz%20Askar%0D%3Cbr%3EFeatherweight%20Bout%3A%0D%20Ahmed%20Tarek%20v%20Abdelrahman%20Alhyasat%0D%3Cbr%3EShowcase%20Featherweight%20Bout%3A%0D%20Mido%20Mohamed%20v%20Yazeed%20Hasanain%0D%3Cbr%3EShowcase%20Flyweight%20Bout%3A%0D%20Malik%20Basahel%20v%20Harsh%20Pandya%0D%3C%2Fp%3E%0A
It Was Just an Accident
Director: Jafar Panahi
Stars: Vahid Mobasseri, Mariam Afshari, Ebrahim Azizi, Hadis Pakbaten, Majid Panahi, Mohamad Ali Elyasmehr
Rating: 4/5
The specs
Engine: four-litre V6 and 3.5-litre V6 twin-turbo
Transmission: six-speed and 10-speed
Power: 271 and 409 horsepower
Torque: 385 and 650Nm
Price: from Dh229,900 to Dh355,000
