Measuring and monitoring the quality of dying in the United Nations ‘Decade of Healthy Ageing’

The World Health Organisation aims to identify metrics to monitor the quality of dying, complementing those proposed for the United Nations’ Decade of Healthy Ageing. Currently proposed criteria for a ‘good death’ are contentious. Needs and priorities vary between individuals and their supporters, across conditions, over time, communities and cultures. Monitoring must take account of sudden or rapid deaths, and assisted dying. Fundamental data collection challenges include who reports, over what timeframe and when. This commentary explores these issues, identifying potentially measurable indicators, ambiguities in their use, and makes recommendations that can form the basis of a practical measurement framework. The aim will be to define a small, meaningful and pragmatic set of indicators that can be collected universally across countries and over time. We define a logic model of candidate variables at different conceptual levels and describe an empirical exercise to start to prioritise and operationalised variables for measurement.