End-of-life care in the Western world: where are we now and how did we get here?

OBJECTIVES: Recent movements in end-of-life care emphasise community care for the dying; however, integrating community with medical care continues to be a work in progress. Historically tracing brain hemispheric dominance, Ian McGilchrist believes we are overemphasising functionality, domination and categorisation to the detriment of symbolism, empathy and connectedness with others. The aim of this historical review is to bring McGilchrist's sociobiological narrative into dialogue with the history and most recent trends in end-of-life care.

METHOD: This review used widely referenced historical accounts of end-of-life care, recent literature reviews on relevant topics and current trends in end-of-life care.

RESULTS: While contemporary end-of-life care emphasises community care for the dying, implementation of these new approaches must be considered in its historical context. McGilchrist's arguments call for a critical consideration of what seems a rather simple change in end-of-life care.

CONCLUSION: We must question whether it is possible to hand death responsibilities back to the community when medical services have largely assumed this responsibility in countries supporting individualism, secularism and materialism.