Most of us favour better life over longer life

24 March 2011
The majority of people would rather improve the quality of life in the time they had left rather than extend their life, a Europe-wide survey has revealed.

The survey of more than 9,000 people in seven different countries across Europe was carried out as part of an EU-funded project led by researchers from King's College London.

Researchers spoke by telephone to 9,339 people in Germany, England, the Netherlands, Belgium (Flanders), Portugal, Spain and Italy, asking them about their attitudes to end of life care.

Asked what their priorities would be if a doctor told them they had a year to live, most of those surveyed (71%) said they would want to improve quality of life for the time they had left; 4% would like to extend life; and 25% said both quality and extending life was equally important.

Across all countries in the survey, being in pain was the symptom or problem that was of most concern, ahead of being a burden on others.

In England, 47 per cent said that pain relief would be their top priority, more important than remaining cheerful or ensuring loved ones were not distressed. Only 8 per cent would focus on tying up loose ends.

The results of the survey will be discussed in Brussels today (Thursday 24 March) at a symposium held by PRISMA, a consortium of experts from nine European and African countries, led by King's College London.

The PRISMA group says greater attention must be paid to quality of life alongside potentially life-prolonging treatments. Currently, the focus is on physical tests such as x-rays, scans and monitoring bloods. PRISMA argues that, although important, these routine tests may miss the effects of the illness on the person and their family. It says assessing psychological, social and spiritual needs is urgently required in order to ensure an adequate response to patient and family priorities.

The group will call for delivery of end-of-life care across Europe to be reviewed in the light of the results, and investment in research increased, in order to meet people's needs more effectively at the end of their lives.

Prof Irene Higginson, Professor of Palliative Care and Policy at King’s College London, said: "There needs to be a fundamental shift in the approach to delivering end-of-life care across Europe. Although individuals’ priorities and needs will differ, it is absolutely clear that people value highly the quality of the time they have left.

“What we need to see is a step-change in the way policy-makers and clinicians across Europe look at end-of-life care, and ensure that people’s priorities and needs inform planning and delivery of these services. Together with an increased investment in scientific research into end-of-life care, this will really make a difference to the quality of people's lives as they face their last weeks and days."

Prof Higginson said only 0.11 per cent of cancer research funding in Britain goes towards research into palliative and end-of-life care.

Professor Stein Kaasa, a member of PRISMA, Professor of Palliative Medicine and an oncologist at the Norwegian University of Science and Technology, said: "It is now the responsibility of all clinicians working with patients with life-threatening diseases such as advanced cancer, to measure and lead others to measure the outcomes of their work against what matters to patients, so they know they are on the right track to providing quality care."

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