End-of-life care pathways as tools to promote and support a good death: a critical commentary

This paper calls into question whether and how end‐of‐life care pathways facilitate the accomplishment of a ‘good death’. Achieving a ‘good death’ is a prominent social and political priority and an ideal which underpins the philosophy of hospice and palliative care. End‐of‐life care pathways have been devised to enhance the care of imminently dying patients and their families across care settings and thereby facilitate the accomplishment of a ‘good death’. These pathways have been enthusiastically adopted and are now recommended by governments in the UK as ‘best practice’ templates for end‐of‐life care. However, the literature reveals that the ‘good death’ is a nebulous, fluid concept. Moreover, concerns have been articulated regarding the efficacy of care pathways in terms of their impact on patient care and close analysis of two prominent end‐of‐life pathways reveals how biomedical aspects of care are privileged. Nonetheless drawing on a diverse range of evidence the literature indicates that end‐of‐life care pathways may facilitate a certain type of ‘good death’ and one which is associated with the dying process and framed within biomedicine