VIDEO: Dean’s Leadership Series explores how public health can enable everyone have a good life until the last breath

November 14/2016

On November 1, 2016, the Dalla Lana School of Public Health in partnership with the Institute for Global Health Equity and Innovation hosted the second Dean’s Leadership Series to explore the provocative question: “A good death for all: what would it take?”

Approximately 200 members of the U of T community and beyond gathered at the National Ballet School’s Betty Oliphant Theatre to participate in a unique forum that featured multidisciplinary storytellers who encouraged the audience to re-think how public health can promote health in life and in death.

“There is an inherent tension in our society with the subject matter of death and how humans should die, and that’s one of the reasons we chose to explore it at this event,” said Howard Hu, Dean of the Dalla Lana School of Public Health. He noted that the Dean’s Leadership Series aims to provide a platform for lively and constructive discussion about how the School can tackle major health challenges that impact local and global populations and increasingly need population-wide perspectives, and potentially, new policies.

The term “a good death” first appeared in the medical literature more than 25 years ago and has since gained popularity, not only in the general medical and nursing professional communities, but also in the mainstream media and policy circles.  It is intended to be an aspiration based on the realization that the increasing life spans that are occurring in most countries — a result of advances in both public health and medicine — have not been accompanied by improvements in the experience of death and dying, and the need to avoid “the soulless death in intensive care” that characterizes the end of life in most modern societies.

In the last few years, both the Canadian and American Public Health Associations identified death as a public health issue. A recent paper by the American Public Health Association urges policy makers to move beyond the traditional domains of medical practice and engage public health strategies — such as improved communication and care coordination at the individual and population levels — to address unmet needs at the end of life.

The storyteller forum was narrated by Professor Alex Jadad, Director of the Institute for Global Health Equity and Innovation,  who acted as the event’s faculty lead, and infused visual and performing arts into the program to help balance the evening’s heavy academic material and intensely emotional discourse.

“Even here tonight, we are heading towards our death, but dying might be the greatest adventure yet, and we all want to have a good one, so how can we feel more comfortable discussing what we would rather avoid, ensuring that we focus on achieving a good life until our last breath?” said Jadad.

Five storytellers guided the audience through an emotional interactive forum that began with funeral director and student midwife Kory McGrath examining the parallels between birth and death. She was followed by Dr. Naheed Dosani, palliative care and family physician at Inner City Health Associates and William Osler Health System, who shared his heart-wrenching personal account of “Terry,” a Toronto homeless man whose social circumstances hindered his ability to access good care at the end of his short life.

The third storyteller was Dr. Denise Marshall, a McMaster family medicine-trained palliative care physician, who recounted personal experiences with close family members who died badly, and how recent exposure to community-driven initiatives have transformed her into a strong social activist.  Dr. Marshall was followed by Maureen Taylor, patient advocate and physician assistant at Michael Garron Hospital, who shared excerpts from a diary she kept in the weeks and months after her husband, the late Dr. Donald Low, was diagnosed with terminal brain cancer.

The final storyteller was Dr. Jennifer Gibson, Director of the University of Toronto Joint Centre for Bioethics, who connected each storyteller’s unique experience with public health and how public health professionals can build strong links among communities, academic institutions and the healthcare system to make a good death possible for all people, anywhere in the world.

“A good death is so much more than a biological or clinical concept. It is about who we are as individuals and as a community — our shared humanity. And yet, we are often so afraid to talk about death,” said Professor Gibson. “This evening’s event opens a ‘conversation that matters’ about death and dying, which we hope will enable us to tap into our shared humanity in seeking to achieve a good life and a good death for all.”

To close the event, Dean Hu called on all audience members to think about how they could further engage with this topic and ended with a call to action:

“You as stakeholders and partners in our community can influence the school’s priorities and through your support, transform what a vibrant and equitable healthy society will look like in the future, both globally and locally.”

Click here for event photos.