UK comes top in global ‘quality of death’ report

The UK has come top in a report ranking the quality of end-of-life care provision around the world that draws heavily from the research of a Glasgow professor.

The Quality of Death Report was commissioned by the Singapore-based Lien Foundation, a philanthropic organisation, and conducted by the Economist Intelligence Unit.

Professor David Clark, director of the University of Glasgow’s Dumfries Campus and founder of the International Observatory on End-of-Life Care, contributed significantly to the report in which he is extensively quoted.

The report scored 40 countries across the globe on four categories: basic end-of-life healthcare environment, availability, cost and quality. Within these categories various factors were considered, including healthcare spending, public awareness, and the existence of a government-led palliative care strategy.

The overall rankings sees the UK ahead of Australia and New Zealand which come second and third respectively, with Ireland, Belgium, Austria, Netherlands, Germany, Canada and the US completing the top ten.

India, Uganda, Brazil and China come at the bottom of the table, with China in particular highlighted for its huge cultural taboo against talking about death, and India noted for having a dearth of pain-killing drugs.

The report, authored by Sarah Murray, states that ‘few nations, including rich ones with cutting-edge healthcare systems, incorporate palliative care strategies into their overall healthcare policy – despite the fact that in many of these countries increasing longevity and ageing populations mean demand for end-of-life care is likely to rise sharply”.

The key findings of the report are:
• The UK leads the world in quality of death, many developed nations must work to catch up,
• Combating perceptions of death, and cultural taboos, is crucial to improving palliative care,
• Public debates about euthanasia and physician-assisted suicide may raise awareness, but relate to only a small minority of deaths,
• Drug availability is the most important practical issue,
• State-funding of end-of-life care is limited and often prioritises conventional treatment,
• More palliative care may mean less health spending,
• Palliative care need not mean institutional care, but more training is needed.

Prof Clark said: “This report, which draws heavily on previous research I’ve conducted, highlights the importance of having good palliative care provision and strategies.

“The UK has performed strongly with Scotland and England both having their own end-of-life care strategies, which focus on shifting palliative care away from specialist care centres to community-based settings to ensure that everyone who needs end-of-life care receives it so that they can die with dignity.”

For more information contact Stuart Forsyth in the University of Glasgow Media Relations Office on 0141 330 4831 or email

Quality of Death Report

First published: 14 July 2010

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