Dying in India is Worse Than Death

A global study of 40 countries places us at the bottom of a quality-of-death index.

If you are about to die from a terminal illness in India, then better hope that you are in Kerala. For, that’s the only state in the country that comes out with any redeeming points in a global study that ranked 40 countries by their end-of-life care. India came 40th. 

Conducted by the Economist Intelligence Unit (EIU), on behalf of Lien, a Singapore-based philanthropic organisation, the study measured ‘quality of death’. Using parameters like availability of painkillers, training for end-of-life care in medical schools, number of hospital beds, doctors and nurses, government spending, etcetera, EIU came out with an index.

To give an indication of how poorly India scored, the United Kingdom and Australia, the best places to die, score 7.9. India, by contrast, gets 1.9, behind even Uganda, which got 2.1.

In India, noted the EIU report, ‘end-of-life coverage extends to only a fraction of those in need’. Indians also undergo a particularly painful death, being ranked last in availability of painkillers. Few doctors or nurses knew how to administer morphine. 

Indians are also in denial about death. The report quoted MR Rajagopal, Chairman, Pallium India, a pioneer of palliative care in Kerala, saying that while relatives are willing to care for dying patients, they “don’t want the patient to be told that they’re dying, so they prevent open communication with the patient”. There is almost zero funding from the government to make death as painless as possible. 

The state of Kerala, however, is an exception, thanks to a combination of government support and community involvement, where volunteers provide services at homes of the chronically ill.  ‘With only 3 per cent of India’s population, the tiny state provides two-thirds of India’s palliative care services,’ says the report.