One thing that is certain in our life is death. Yet, most of us are scared to discuss this subject. We would like to open a forum to discuss end of life care and related issues.

Dying with dignity - why is this a taboo subject? 

“The fear of death follows from the fear of life. A man who lives fully is prepared to die at any time.” Mark Twain.

Dying is one of life's few certainties, but many of us avoid discussing it.

What is palliative care?

Palliative care means patient and family–centered care that optimizes quality of life by anticipating, preventing and treating suffering.   Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social and spiritual needs to facilitate patient autonomy, access to information and choice.

What is a good death?

Is there such a thing as a 'good death'? Certainly, there are situations at the end of life where things are calm and gentle and symptom-free, and where those involved understand exactly what is happening.

But the popular conception of a good death, as so often depicted on screen, where families exchange meaningful sentiments and sunlight bathes the room, is unrealistic. So is death without sadness. We can hope for the absence of pain, of shouting and confusion, and of fear. But there will be no absence of sadness. Sadness and death are inseparable partners.

End of life experience is unique – determined by circumstances often beyond the control of the dying.

Standards of palliative and end of life care vary vastly between countries and communities. What is certain is that much of the suffering during the twilight period of peoples’ lives are preventable.

What can we do to break down the taboos associated with death? What can we do to reduce unnecessary suffering at the end of life?

One of our Vice Chairs, John Dugaw (jdugaw@gmail.com) has vast knowledge about end of life issues and leads discussion groups on the topic. He would welcome contact with those with experience and views about this.

Rotarians do care

Many Rotary clubs support local care homes, hospices and other similar institutions, often through fund raising.

Where appropriate, should we not explore the possibility of creating an alliance of the multiple and varied organisations involved in the care of the elderly and set minimum standards for home as well as institutional care?


England's health watchdog has put forward new draft guidance to improve the care of adults in their last few days of life.

It comes after concerns that misuse of the previous system - the Liverpool Care Pathway - led to some patients being deprived of water and food.

The guidelines encourage staff to involve patients and relatives in decisions and to communicate well.


John E. DugawJr. MD., FAAFP, Family Physician/Geriatrician 



Asking the tough questions

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