England: The best place to die

(Winter sunset, Sutton Harbour, Plymouth, England. Copyright S.P. Tiley/Muffindogpress)

The Economist Intelligence Unit has produced a white paper noting that the UK is No. 1 as the place to be when one is dying.

That was a comforting finding; lately, the morning talk shows on BBC radio have lamented the poor quality of British end-of-life care.

All things are relative. Next to the rest of the world, despite ranking very low on one aspect of end-of-life care, Britain is ranked No. 1 overall. It is in quality of life, toward the end of that life, that Britain apparently excels. The report notes that, “The UK has led the way in terms of its hospice care network and statutory involvement in end-of-life care, and ranks top of 40 countries measured in the Index.”

Possibly the ranking is high because palliative care is available, and there is even help for family and those others who are not medical professionals but are caring for the ill or dying.

I could ponder long about why this is so, but I won’t. I think I know, and I think I came to my conclusion long before becoming an ex-pat in Britain. For all its faults, and there are some to be sure, Britain remains dedicated at a fundamental level to the welfare of all its citizens. It was not, of course, always so. Just this morning, a talk show dealt in depth with the horrors of the workhouse, where the orphaned, widowed, poor, sick and elderly were once sent. The workhouses (think of the movie Oliver! if a visual escapes you) replaced community care; workhouses began to be replaced during Victoria’s reign and were, of course, history long before the National Health Service was created in the UK after WWII. Currently, the radio presenter noted, care for the aforementioned pressured groups has been returned to the community, with assistance from governments up the line.

Before my life took the unexpected turn of marriage to a Brit, making this the natural place to perch after we had decided to leave the US and its myriad fundamentalist brain- and spirit-bashing groups and movements, I had intended to live in France after retirement, but move to my ancestral Ireland (Republic of Ireland, not Northern Ireland, as in Ulster, as in UK) when I felt death would be imminent. Naturally, through it all, I remain a U.S. citizen, simply one on "extended leave."

I’m happy to say that, had I done that, I’d not be in bad shape. France’s health care system is generally regarded as among the best in the world, if not the absolute top. But it’s end-of-of-life ranking is quite low. So, living in France=good. Dying in France=not so good.

But Ireland is ranked No. 4 by The Economist in end-of-life care.

Unbeknownst to me, my original plan was pretty good.

But the plan I ended up with, married to Simon and living in incredibly gorgeous southwest England, is even better.