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End of life care in no way rations health care in the United Kingdom.
What it does is to recognise that, at some point, we must die, and that heroic measures become pointless and cruel if they are not working.
Hospice programmes in the United States also recognise that, but the funding under the present system is limited and probably does not allow those who wish to die at home to have sufficient support. The hospice movement is hugely popular in the United Kingdom. It started, in its modern form, as something out of the Christian tradition, founded as it was by Dame Cicely Saunders, who was a devout Anglican. However, people of all faiths support hospices, and the North London Hospice, which provides home care as well as impatient care, is a multi faith hospice (as opposed to non-denominational). It has volunteers of all faiths and patients of all faiths, and it caters to their spiritual needs. End of life care recognises pain that is physical and deals with it. But it also recognises emotional and spiritual suffering, and, at its best, can allow people to die comfortably, alert, having made their peace with family and friends, made their peace with God, and said their goodbyes. I have never understood why this should be regarded as anything other than wonderful, and, having watched both my parents receive end of life care at home, I know I would not wish to die any other way, if I get the choice. So highly regarded is end of life care and the skills that go with it in the UK that it is now- finally- being extended nationwide beyond cancer, AIDS, and Motor Neuron disease to all those who are dying of whatever cause.