On where to die, patients and their families must have a choice

The option to spend our final hours at home, surrounded by family and medical support, deserves to be explored in light of Hong Kong’s ageing population

PUBLISHED : Monday, 04 July, 2016, 1:15am
UPDATED : Monday, 04 July, 2016, 1:15am

If given the choice, most terminally ill patients may prefer spending their final moments at home. Yet, modern medical care makes dying in hospital the default option. Increasingly, more overseas countries have provided dying patients with the choice of staying at home instead of an institution.

The idea of a comfortable home death is still uncommon in Hong Kong, partly because of low public hospital charges and the bureaucratic red tape involved in handling deaths that happen outside medical institutions. Cramped living spaces, a lack of support services and traditional beliefs mean there is even less incentive for a change. That explains why more than 80 per cent of deaths in Hong Kong take place in hospitals.

It is good to learn that the government is exploring the home option. A study led by former health minister Dr Yeoh Eng-kiong at Chinese University is expected to shed light on the way forward. The findings will cover the provision of general end-of-life care and will be ready by the third quarter of this year at the earliest, according to the Hospital Authority.

There are, of course, pros and cons for different options. While hospitalisation enables suitable care and treatment for the patients, it adds to the burden on the health care system. The institutionalised environment also makes the journey more unpleasant for the patients and their families. Patients usually feel more at ease when supported by family members and friends at home. The familiar setting also provides a greater sense of comfort and helps achieve personal closure. But the stress on home caregivers can be overwhelming. Based on overseas experience, patients returning to hospital for better care is not uncommon.

The matter is not as straightforward as it seems. Personal preferences aside, there are also issues like the need for a legislative amendment on notification of death and the provision of home medical support. But there is no reason why patients should not be given more options. The question is even more pertinent in light of the pressure arising from an ageing population.