title: Death: a foe to be conquered? Questioning the paradigm.
abstract: There are few certainties in life-death is one of them. Yet death is often thought of today as the 'loss of the battle' against illness, where in traditional societies it was the natural, meaningful, end to life. Medical knowledge and technologies have extended the possibilities of medical care and increased our life span. People living in most developed countries today can expect to survive to an advanced age and die in hospital rather than at home as in the past. Owing to these and other historical, cultural and social factors, our views on death have been skewed. Medical technology provides an arsenal of weapons to launch against death and the 'war against disease' has entrenched itself in medical philosophy. We now primarily experience death through the lens of a camera. Representations of 'death as spectacle' distort our perceptions and leave us ill-prepared for the reality. Additionally, death as a natural consequence of life has become much less visible than it was in the past due to our longer life expectancies and lack of infectious disease. The continued thrust for treatment, wedded with a failure to recognise the dying process, can rob individuals of a peaceful, dignified death. Progress being made in Advance Care Planning and palliative care is limited by the existing paradigm of death as a 'foe to be conquered'. It is time for a shift in this paradigm.
authors.affiliation: Cabrini-Monash Department of Medicine, Cabrini Institute-Cabrini Research and Education Precinct, 154 Wattletree Rd c/o 183 Wattletree Rd, Malvern, Victoria 3144, Australia.
authors.forename: Anthea
authors.initials: A
authors.lastname: Gellie
authors.affiliation: Cabrini-Monash Department of Medicine, Cabrini Institute-Malvern, Victoria, Australia.
authors.forename: Amber
authors.initials: A
authors.lastname: Mills
authors.affiliation: Cabrini-Monash Department of Medicine, Cabrini Institute-Malvern, Victoria, Australia.
authors.forename: Michele
authors.initials: M
authors.lastname: Levinson
authors.affiliation: Cabrini-Monash Department of Medicine, Cabrini Institute-Malvern, Victoria, Australia.
authors.forename: Gemma
authors.initials: G
authors.lastname: Stephenson
authors.affiliation: Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Flynn
mesh_terms: D000367:Age Factors; D000375:Aging / Q000523:psychology*; D001293:Attitude to Death; D002423:Cause of Death; D017281:Cost of Illness; D006801:Humans; D008017:Life Expectancy; D010347:Patient Care Planning; D011639:Public Opinion; D011788:Quality of Life; D012297:Right to Die; D013727:Terminal Care
keywords: ageing; attitude to death; care goals; death; end of life care; older people; terminal care