Rapid Response Systems and the Management of End of Life

Over the last decades, dying has become medicalised in our society. The reasons are complex but include the reluctance of society to talk about dying and the concentration on ageing well without the obvious corollary of how to die well. Health plays its part by applauding the development of medical miracles with the emphasis on prolonging life at all costs and not accepting dying and death as a normal part of living. Ironically, it was the development of rapid response systems which drew our attention to dying in hospitals. The rapid response systems were designed to prevent death and other adverse events such as cardiac arrests. Soon after the implementation of rapid response systems, large studies found that up to one-third of all rapid response system calls were for people near the end of life. In other words, people were not normally recognised as dying by the health system until they were in the last stages of life. The increasing age of our population and the fallback position of admitting the elderly frail to hospitals as they near the end of life have increased our attention to empowering people to make their own choices about how they wish to live the last phases of life.