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Anticipating, recognising and talking about dying: Can we close the gap?
1Royal College of Physicians of London, UK.
Future Healthcare Journal
|April 13, 2026
Summary
Healthcare professionals often avoid discussing end-of-life care, leading to delayed recognition of dying and missed opportunities for quality care. Addressing this reluctance is crucial for improving the experience of dying patients.
Area of Science:
- Medical Sociology
- Palliative Care Research
- Healthcare Ethics
Background:
- A pervasive culture of avoidance surrounding discussions of dying exists within hospital-based National Health Service (NHS) healthcare.
- Senior healthcare staff often exhibit a disinclination to acknowledge or discuss the possibility of death.
- This avoidance creates a 'hidden curriculum' that devalues essential end-of-life care practices.
Purpose of the Study:
- To analyze the impact of the avoidance culture on end-of-life care within the NHS.
- To highlight the consequences of late recognition of dying and missed palliative care referrals.
- To advocate for a shift in perspective, emphasizing the importance of compassionate end-of-life communication.
Main Methods:
- Qualitative analysis of healthcare professional attitudes towards discussing death.
- Review of existing literature on end-of-life communication in hospital settings.
- Exploration of the concept of a 'hidden curriculum' in medical education regarding dying.
Main Results:
- The avoidance culture leads to late recognition of dying.
- Opportunities for patients to reorder priorities and improve quality of life are frequently missed.
- Late referrals for palliative care support are a common consequence.
Conclusions:
- Medical reluctance to discuss dying needs to be addressed.
- Dying should be demedicalized and viewed as a precious time deserving focused attention.
- Restoring public and professional understanding of 'ordinary dying' is essential for better patient care.
Keywords:
CommunicationDelayed referralEnd of life careHidden curriculumMedical educationOrdinary dyingPublic educationMore Related Videos
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