The concept of a ‘good’ death in pre-hospital care

Paramedicine has changed dramatically throughout the last twenty years. With significant changes in both the education that underpins paramedic practice and the technology now used to enhance it. The quality of care being provided to the service-user has arguably never been so high.

What was once merely a transportation service has now made the transition into a profession with legally accountable clinicians who are expected to base their decisions on the most up-to-date, available evidence. With this increased responsibility however, comes increasingly higher expectations to protect and preserve life and patient outcome.

It might be argued that for the majority of practitioners, death is viewed primarily as a defeat in the face of an uncontrollable force of nature, one that will undoubtedly affect us all at some point of our personal and professional lives and that all should be done to prevent it; especially at this festive time of year.

However, the concept of paramedics being able to assist in the provision of a ‘good death, a peaceful death, or helping someone to die well’ is one that is often misunderstood, shrouded in fear of de-registration, punitive repercussions and generally lacking in evidence-based research (Nellist, 2011).