End-Of-Life Decision Making: A Cross-National Study 2007

This analysis of end-of-life decision-making offers a broader perspective than that found in the extensive existing literature on the subject, offering an international comparison. Experts from twelve countries analyse death-related issues in their countries, discussing topics such as healthcare costs, advance directives or wills, pain management, and cultural, social and religious factors. The countries selected for the study - Brazil, China, Germany, India, Israel, Japan, Kenya, the Netherlands, Taiwan, Turkey, the United Kingdom and the United States - represent a mix of eastern and western countries, developed and developing countries that are rarely considered together in analyses of these issues. This is the first systematic attempt to analyse end-of-life issues in many of these countries. Each author describes the various factors influencing end-of-life decisions: the estimated costs of dying, including healthcare costs; the proportion of deaths in hospitals, hospices and at home; the prevalence and diversity of advance directives; the combination of advanced technology and palliative care; government policies on end-of-life decisions, assisted suicide and euthanasia; and cultural, social and religious influences. The results show that there are large differences between countries, even in terms of framing these issues. Academics, policy makers and practitioners can benefit from the extensive information in these essays on how different nations deal with death.