Measuring and monitoring the quality of dying in the UN Decade of Healthy Ageing.

Abstract

WHO aims to identify metrics to monitor the quality of dying, complementing those indicators proposed under the UN Decade of Healthy Ageing. However, the proposed criteria for a good death are contentious. Needs and priorities vary between individuals and their carers, across conditions, over time, and across communities and cultures. Monitoring should also consider sudden or rapid deaths and assisted dying. Fundamental challenges in data collection include who reports, over what timeframe, and when. This Personal View explores these challenges, identifying potentially measurable indicators and ambiguities in their use, and offers recommendations towards a practical measurement framework. We aimed to define a concise, meaningful, and pragmatic set of indicators that could be collected and applied universally across countries and over time. We define a logic model of candidate variables at different conceptual levels and describe an empirical exercise for prioritising and operationalising these variables for measurement.