Dying cannot be understood properly, or responded to well, without recourse to the connections between the dying experience and the larger social structures that make up a social and civic community

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In the first issue of the Humanitarian Health Digest, Paul Spiegel stresses the need to highlight the lack of palliative care in humanitarian emergencies. Both refugees and nationals with life-limiting illnesses need more dignified, cost-effective care, he argues

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Many people fear death partly because of the perception they might suffer increasing pain and other awful symptoms the nearer it gets. There’s often the belief palliative care may not alleviate such pain, leaving many people to die excruciating deaths

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Our Katherine Heinze, Heidi Holtz and Cynda Rushton write, “Palliative care (PC) clinicians are faced with ever-expanding pressures, which can make it difficult to fulfill their duties to self and others and lead to moral distress.”

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Ethicists can step in. It’s not uncommon for nursing staff to report moral distress after administering palliative sedation to a patient who dies shortly afterward. With comments from our Cynda Rushton

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The way the medical system handles death is broken, and requires bigger fixes than freedom of consumer choice. Many of us will face quandaries far too nuanced to be solved by aid-in-dying laws

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Russia has strict rules on dispensing painkillers. Family members say some cancer patients killed themselves because they could not obtain the medicine and the pain was too great

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“Death is nothing at all,” the English theologian Henry Scott Holland wrote a century ago in a reflection that is often quoted at funerals. Death is but life extended, Holland said: “I have only slipped away to the next room. Nothing has happened. Everything remains exactly as it was.”

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