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Daily Archives: February 5, 2022
(New Report) Microserver Market In 2022 : The Increasing use in Media Storage, Data Center, Data Analytics, Cloud Computing is driving the growth of…
Posted: February 5, 2022 at 5:54 am
[92 Pages Report] Microserver Market Insights 2022 This report contains market size and forecasts of Microserver in United States, including the following market information:
United States Microserver Market Revenue, 2016-2021, 2022-2027, (USD millions)
United States top five Microserver companies in 2020 (%)
The global Microserver market size is expected to growth from USD 30200 million in 2020 to USD 51350 million by 2027; it is expected to grow at a CAGR of 7.4% during 2021-2027.
The United States Microserver market was valued at USD million in 2020 and is projected to reach USD million by 2027, at a CAGR of % during the forecast period.
The Research has surveyed the Microserver Companies and industry experts on this industry, involving the revenue, demand, product type, recent developments and plans, industry trends, drivers, challenges, obstacles, and potential risks.
Get a Sample PDF of report https://www.360researchreports.com/enquiry/request-sample/19527161
Leading key players of Microserver Market are
Microserver Market Type Segment Analysis (Market size available for years 2022-2027, Consumption Volume, Average Price, Revenue, Market Share and Trend 2015-2027): Hardware, Software, Service
Regions that are expected to dominate the Microserver market are North America, Europe, Asia-Pacific, South America, Middle East and Africa and others
If you have any question on this report or if you are looking for any specific Segment, Application, Region or any other custom requirements, then Connect with an expert for customization of Report.
Get a Sample PDF of report https://www.360researchreports.com/enquiry/request-sample/19527161
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Chinnery’s Tribute to Tanka People of Macau Leads Bonhams Travel and Exploration Sale – Martin Cid – Martin Cid Magazine
Posted: at 5:53 am
London The peripatetic life of the 19thcentury Irish painter George Chinnery (1774-1852) took him from the Tipperary of his birth to London, then to Serampore in West Bengal via Madras, Calcutta and Dacca. Fleeing his creditors, he arrived in Macau in 1825 and made the island his home until his death in 1852. He became fascinated by the artistic possibilities of Macaus shoreline and the local tradespeople going about their everyday lives.One of his paintings on this theme,A Tanka boat dwelling with Tanka boatwomen and pigs, Macauleads the Travel and Exploration sale in Knightsbridge on Wednesday 2 March. It is estimated at 15,000-20,000.
Rhyanon Demery, Bonhams Senior Picture Specialist, said: A Tanka boat dwelling with Tanka boatwomen and pigs, Macauvividly depicts members of the Tanka people a distinct and ancient ethnic group who lived along the shore of Macau. Often viewed as outcasts by the Chinese authorities Tankas lived on junks,tankbeing the Cantonese word for boat andkathe word for family. Today they are more usually known as Boat People and, although many have now built lives on dry land, they preserve the unique culture that so captivated George Chinnery nearly 200 years ago.
Other highlights of the sale include:
Elsewhere in the sale there is a wealth of interesting lots associated with polar exploration.
Highlights include:
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Former VP Pence rejects Trump claim he could have overturned election – Macau Business
Posted: at 5:53 am
Former US vice president Mike Pence said Friday that he had no right to overturn the 2020 election and former president Donald Trump was wrong to claim he could have done so.
Pence dismissed Trumps assertion he could have blocked Democrat Joe Bidens victory when he presided over the January 6, 2021 certification by Congress of the presidential election results.
President Trump said I had the right to overturn the election but President Trump is wrong, Pence said in a speech to the conservative Federalist Society in Florida.
I had no right to overturn the election, he said. The presidency belongs to the American people and the American people alone.
And frankly there is no idea more un-American than the notion that any one person could choose the American president, he added.
Both Pence and Trump are potential presidential candidates in the 2024 election, and their public disagreements are seen as early maneuvering in the race to become the Republican Party nominee.
Trump, who has falsely claimed the election was stolen and marred by fraud, said in a statement last weekend that Pence, as presiding officer, could have overturned the Election.
Pence has said previously that he did not have the power to block certification, but Fridays comments were his most forceful to date.
Pence told the Federalist Society conference that he did his constitutional duty.
There are those in our party who believe that as the presiding officer over the joint session of Congress that I possessed unilateral authority to reject Electoral College votes, Pence said.
Under the Constitution, I had no right to change the outcome of our election.
And Kamala Harris will have no right to overturn the election when we beat them in 2024, Pence said in a reference to Bidens vice president.
Pence a staunch loyalist when Trump was in office also called the January 6 assault on Congress a dark day in the history of the United States Capitol.
Five people died when Trump supporters stormed the Capitol following a speech by the then-president during which he repeated his false claims to have won the election.
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Germany’s daily COVID-19 infections near 250,000 amid Omicron wave – Macau Business
Posted: at 5:53 am
Germanys daily COVID-19 infections reached a new all-time high, with 248,838 new cases registered within 24 hours, the Robert Koch Institute (RKI) for infectious diseases said on Friday.
The countrys seven-day COVID-19 incidence also continued to rise and hit a new record of 1,349.5 infections per 100,000 inhabitants, according to the RKI.
The Omicron wave is slowly reaching the elderly population and more outbreaks are being reported in nursing homes, the RKI said on Twitter.
Despite record figures, the number of COVID-19 patients treated in intensive care units (ICUs) remained at around 2,300, far below the peak of around 5,700 during the height of the second wave in early 2021, according to the German Intensive Care Availability Register (DIVI).
Studies suggest that the Omicron variant causes a lower share of hospitalizations compared to infections with the Delta variant in infected persons with complete vaccination or booster vaccination, the RKI said in its latest weekly report.
So far, more than 74 percent of Germanys population had been fully vaccinated. A slight majority of Germans, or 53 percent, continued to be in favor of mandatory COVID-19 vaccination for all adults, according to a DeutschlandTrend survey published by broadcaster ARD on Thursday.
Meanwhile, Minister of the Interior Nancy Faeser said Friday that the government had made contact to the top management of the international messaging service Telegram to discuss hate speech on the platform.
In an initial constructive discussion on further cooperation, we agreed to continue and intensify the exchange, Faeser said on Twitter.
The messaging service caught the attention of German authorities after radical opponents of the countrys COVID-19 policies organized themselves via the platform. The Federal Criminal Police Office (BKA) set up a task force last week to identify and prosecute suspects.
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WHO calls for global inequality in cancer treatment to be addressed – Macau Business
Posted: at 5:53 am
On World Cancer Day this Friday, the World Health Organization (WHO) called for the gap in the availability of cancer care in high and low-income countries to be addressed.
Globally, cancer is one of the leading causes of death, with an estimated 20 million people diagnosed and 10 million deaths from the disease in 2021, the WHO said.
These numbers will continue to rise in the decades ahead, it noted.
Though all cancers can be treated and many can be prevented or cured, available care reflects global inequality. Comprehensive treatment is available in more than 90 percent of high-income countries, but less than 15 percent of low-income countries, WHO said.
Cancer services are covered by national healthcare services in only 37 percent of low- and middle-income countries, compared to at least 78 percent of high-income countries.
WHO highlighted the role of national cancer centers, saying they can be a one-stop shop for prevention, diagnosis, multidisciplinary treatment and supportive care, which makes it easier for patients to navigate services with concentrated expertise, and leads to better results.
Radiotherapy is among the most cost-effective, efficient and widely-used treatments for cancer, but worldwide access remains inadequate. Due to the COVID-19 pandemic, many countries have also experienced disruption to cancer screening and treatment, WHO noted.
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Ghostwire: Tokyo is more Watch Dogs 2 than The Evil Within, but that’s OK with me – PC Gamer
Posted: at 5:52 am
Ghostwire: Tokyo's hands-off preview pleasantly surprised me. Horror often isn't my thing. A game with ghosts at the forefront isn't, on the whole, an experience I would chaselet alone one with strange slenderman-like monsters and headless spirit school children. However, watching 30 minutes of gameplay changed my mind dramatically. Ghostwire is more like a Japanese ghost hunting Watch Dogs 2 rather than a city wide PT, and that's a-okay with me.
Though developer Tango Gameworks made the delightfully horrifying The Evil Within series, Ghostwire isn't trying to terrify you in the same way. This early look set my mind at ease about how scary the game was going to be. I'm not sure that's entirely a good thing for those searching for a deeply disturbing horror experience but for me, a neon-drenched ghostly action game is far more appealing.
You play Akito, a man on a mission to save Tokyo, and by extension, your family. Everyone in the city has been transformed into spirits who are slowly being lost to the void. The game nonchalantly mentions this is about 200,000 souls to save at leastno biggie. Luckily you don't have to save Tokyo on your own, because you've got ghost hunter KK living in your head. He's your guide and companion through this mess, and helps equip you for this hellish adventure.
You have a litany of tools at your disposal for dealing with these spectral forces. Your main weapon is cool dancey hand magic. Doctor Strange eat your heart out. The game calls it Ethereal Weaving and these moves can be blasted at your foes, damaging them until a core is revealed. The same Weaving technique can whip onto the core and tear it out of its monster, essentially exorcising the demon or 'visitor'. Fail to take your opportunity for an exorcism and they'll recover, so be quick..
Ethereal Weaving can also be used as a traversal tool. Though you will be spending a lot of time on the ground, the rooftops are also an essential part of Ghostwire: Tokyo's story. Hooking onto bird-like spirits called Tengu will catapult you upwards and get you to all-new vantage points.
Additionally, you take KK's spirit bow. Yeah, the game gives you a bow and you shoot phantom arrows. I'm a massive archery nerd so this was kind of hilarious to me as a concept but it's good the game gives you a solid long-range option to work with.
With these tools you sneak and scuffle your way through Tokyo, seeking out Torii gates to cleanse, revealing more of the map and loosening the hold of the bad guy, Hannya. His motivation seems to be that spirits are better off in the ether and that's where Akito and KK disagree.
The most interesting section of the preview was a timed event wherein Akito became trapped in a building-sized spirit box. The block of flats became surrounded by a wall which threatened to close and demolish the structure with you inside it. To prevent your death Akito has but a few minutes to find and destroy several orbs casting the spell. As this happens the indoor environment of this building became a geometric nightmare. Doctor Strange comes to mind once again as you're spiriting across the ceiling of a stranger's home and scrambling through landscape doorways. The effect is really nifty and you become apprehensive as you wonder what beasts could be lurking in this puzzling purgatory with you.
In between these larger elements came tidbits of world-building. When you save the souls of Tokyo residents, you have to upload them into a safebox via telephones dotted around the city. Also, because all the shopkeepers have been ghosted, stores are now operated by spirit cats who will call you a "humeown". Excellent.
For me the environment, enemies, and action all look excellent in Ghostwire: Tokyo. I have my reservations admittedly, like the constant uploading of souls and the now all-too-common map unlocking mechanic popularised by Assassin's Creed. I'm also curious as to how any of the city will feel or look different as you explore. Hopefully we'll have a wide variety of districts and enemies to fight.
Overall, I'm feeling very positive about the upcoming release of Ghostwire: Tokyo. We've just seen that the release date for the game is set for March 25, 2022 and I'm excited to see more.
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Emily Atack unveils new outlook on life as she moves on from Jack Grealish scandal – The Mirror
Posted: at 5:52 am
The TV actress was embroiled in a love scandal for the latter half of 2021 as she was linked to footballer Jack Grealish who has been in a decade-long romance with his childhood sweetheart
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Emily Atack says she 'always has to move house'
Emily Atack has flashed her toned tummy as she waxed lyrical about the benefits of exercise and dining with friends as she looks ahead to a busy few months.
The 32-year-old star ended the last year under something of a storm cloud as rumours of a romantic liaison with professional footballer Jack Grealish, 26, seemed to follow her everywhere she went.
But now she seems to be putting the drama surrounding herself and Jack who has been in a 10 year relationship with 25-year-old childhood sweetheart Sasha Attwood behind her.
Taking to Instagram on Tuesday, Emily shared a collection of photographs of herself alongside various family members, friends, and her pet dog as she teased a string of upcoming secret projects.
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Selecting a photo of herself in a fitness top and matching print exercise leggings, Emily gave an insight into her current state of mind.
Uploading the snaps to her main feed, the TV star wrote: Its amazing what a bit of exercise, slightly earlier nights, and cooking in your kitchen for your mates can do for your scrambled mind.
Ive got amazing announcements to make this week, and Ive had two weeks of freedom to get myself together, move into my new home, and surround myself with the people and the things that make me happy, all ready to take on the fresh madness thats about to begin.
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She added: Learning to look after myself better. For now anyway and added a crazy face emoji.
Photos showed Emily reviewing fresh fruit at a local market, her brother George tending to her window-box flowers, plates of food, and her sun-soaked kitchen.
Further photos showed her posing in businesswear for a mirror selfie, laughing and drinking with a male friend, posing with her father, Keith, for a selfie, posing with a gaggle of girls including her sister, Martha and a snap of herself gazing lovingly at her dog, Penny.
Emily has a trio of upcoming acting roles in post-production with a part in a sci-fi drama called Dark Cloud, a comedy called Lifecoach, and a romantic thriller called Felo De Se all coming up.
Last month, Emily got candid during an Instagram Q&A with fans hinting at some of the strain she was under in 2021 when reports raged that she had enjoyed a fling with footballer Jack.
Asked if she was happy, Emily replied: "Not always! I definitely have my struggles. But I try to fill my life with as much love as possible.
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"I definitely know how to have fun and I know how to help myself feel better. I dont always do the right thing, but Im surrounded with incredible support when I sometimes lose my way."
And taking to her Instagram Stories at another time, the Celebrity Juice star shared a poem from Yung Pueblo which may have alluded to her rumoured romantic woes from last year.
The poem read: "I was never addicted to one thing, I was addicted to filling a void within myself with things other than my own love."
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Safa Sahin’s Otherworldly Maximalism Is a Footwear Revolution – Highsnobiety
Posted: at 5:51 am
In an industry addicted to retro, Highsnobiety presents The New Vanguard of Footwear, a dedicated hub that celebrates the pioneers from around the globe who are changing the face of what today represents a multi-billion dollar industry.
Trying to sum up Safa Sahins design methodology is no easy task. In fact, when I ask the man himself to describe his approach in a few words, he has a think before laughing, saying that it should be someone else's job. Fair enough. How about absurd, otherworldly maximalism?
Having cut his teeth at smaller gigs across Turkey, Sahin eventually found his way to Nike where he honed his craft, working on some of Bevertons biggest and most advanced footwear projects. It was during this time he also began to make waves online, getting in on Instagram while it was still bubbling. Operating to an almost Stakhanovite work plan of uploading one new render every day, it wasnt before long he had amassed well over 50,000 followers on the platform. Naturally, professional suitors soon followed.
Adept at drawing up a pair of fashion week heels as he is a pair of bonkers kicks, Sahin eventually made the leap from sportswear into the luxury space. These days, he is a trusted lieutenant of Balmains Olivier Rousteing, bringing to life some of the craziest and forward-thinking footwear on the planet.
Keen to find out more, I interrupted Paris Fashion Week for a chat with the man himself.
Was there a particular sneaker that inspired your design journey as a kid?
I'm from Turkey. I grew up in a small city called Yozgat. I came to Istanbul to study footwear design at university, which was a big decision. Before that, I was a graffiti artist. I was a shoe shiner when I was 11-years-old, which looking back, is when my career technically started. Id take worn-out shoes and clean them up; painting and replacing parts. The type didn't matter. When it came to sneakers, I was always obsessed with Converse. Even when I was studying at university, it was my dream to work for the brand. I couldn't find an authentic pair because I was living in a really small town. My first sneaker was a pair of fake Converse.
So eventually you graduate from university. Where do you go from there?
I did an internship at a very small company for four months. After that period, they didn't like my designs. They came to me and said, If you don't change your designs, we're going to fire you. A week later they did!
The second job I did wasnt as a designer. It was more working with glue and putting lining and leather together. During this period I realized that I don't have good knowledge about art, so I decided to study fine art. As a graffiti artist, I already knew I had the talent. I went back to university to study for five more years. Id dabble in the shoe industry whenever I had some spare time.
I didn't get any money from my family. I earned my money to make my school payments and apartment. Sneakers were not popular in this period. Plastic shoes, high heels, and casual shoes were, but not sneakers. When Y-3 started launching sneakers, that blew my mind. Particularly models like the Qasa.
What did studying fine art teach you that graffiti didnt?
My mind totally changed. We were taught to be free. Nobody can judge you. If you draw this curve or if you draw differently to others, this is your style. This touched me and changed my mind.
It informs me to this day in that I am always trying to bring something new and not follow others. I still respect tradition I'm really curious about the techniques. But I am focusing on bringing something new.
How did your move to Nike come about?
I started to learn more about digital renders. Instagram also started around this time, and I posted every day. I targeted doing one per day for six months, no matter what. This idea came from Steve Jobs. He said to put one dot every day. One day you will realize that the dot is actually huge. After six months, I got an offer from Nike. They said, We were following you for a long time.
How did things develop from there?
They invited me to Portland. It was a big problem for me, because I couldn't speak English. They sorted a translator and told me to focus on design. Work was done about 5 PM and she would then come to teach me English for two hours every day. Every six months they collected all the designs. Some of them would go to market, some of them inspired other designers.
After Nike, what was the next step?
When I worked at Nike I was still posting stuff like high heels. I didnt have many friends there because of the language barrier, so I was focused on my work. I started getting offers from big houses and big brands, including adidas. YEEZY contacted me three times. Louis Vuitton, Versace, Giorgio Armani, Marc Jacobs, Jimmy Choo There were so many brands.
So why did you end up at Balmain?
They contacted me before, but they didnt want a freelancer at the time. I was in Vietnam for production and looking at factories when my friend from PUMA called. He said, I'm creating now the team for Balmain. Would you like to join me as had of sneaker design? He was one of the big reasons.
What are the immediate differences between working for a sports giant like Nike versus a luxury brand like Balmain?
The freedom. For example, when I came to interview for Balmain with Olivier Rousteing, I had another meeting with Louis Vuitton for the adult sneakers design position. I said to Olivier, Hey, Olivier, I have another interview tomorrow with Louis Vuitton. And he said, You can go. You have a talent. Probably it would be nice, but you will not be free there. It is exactly the same with Nike. Before starting the design project, you have to abide by certain rules stuff like the text and thickness of the sole.
Olivier was different. He told me, If you select us, I will keep you totally free. And you can do exactly what you show on your portfolio. He keeps me free and has been true to his word. I have more freedom here to make crazy sneakers.
Do you care about making something that falls in line with the Balmain DNA or do you have a free canvas to create?
Its a bit of both. Right now Im focusing on the cushioning system, like the Bbold. It still has the Balmain gold, but its totally new. Weve since rolled the system out to other models high and low. Evolution is the best word to describe this.
How do you predict sneaker design will progress in the future?
I think the silhouette will fundamentally change and they will bring in more technical things. Comfort and materials everything will be combined. It's not separate from each other. This is true of most industries, from fashion to cars.
Finally, how would you describe your aesthetic?
Experimental. Futuristic. Trying think outside of the box. I don't know, actually. There are so many words. I also like tradition. Maybe a critic should come up with it for me!
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Safa Sahin's Otherworldly Maximalism Is a Footwear Revolution - Highsnobiety
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New ITR filing: How much do you have to pay for filing updated income tax return – Mint
Posted: at 5:51 am
Finance Minister Nirmala Sitharaman has not announced any change in the income tax slab rates while presenting Union Budget 2022. However, the Finance Minister has given some respite to people filing their revised Income Tax Return (ITR). FM has announced that the revised tax filing window will remain open for two years from the year of assessment in case of less filing of tax.
"To provide an opportunity to correct such errors, I am proposing a new provision permitting taxpayers to file an updated return on payment of additional tax. This updated return can be filed within two years from the end of the relevant assessment year," Sitharaman said in her Budget speech.
How much do you have to pay for filing an updated income tax return (ITR)?
"It is proposed that an amount equal to 25 per cent or 50 per cent as additional tax on the tax and interest due on the additional income furnished would be required to be paid," said the Budget memorandum.
When reporting such additional income, the taxpayer would be required to pay additional tax. This offer does not come cheap. Those who wish to come clean have to pay an extra amount expressed in percentage terms of tax and interest payable at the time of furnishing the ITR if the updated ITR is furnished within 12 months (25%) or after 12 months but within 24 months (50%),"said tax expert Balwant Jain.
He added that the introduction of Annual Information Return (AIS) has instilled a sense of fear in the mind of taxpayers who have been evading paying full tax. Since the government does not have the requisite bandwidth to track and chase the taxpayers who have not fully declared their income or have not filed their ITR where the tax impact is not very significant, it has come out with a novel idea to offer the taxpayer the chance to come clean on their own but with certain additional cost by uploading an updated ITR by paying the tax within two years from the end of the assessment year before the income tax departments find it out," he said.
While all taxpayers have the avenue of revising their tax returns in a limited window of five months from the due date of filing of tax returns, now the updated return can be filed within a period of two years from the end of the relevant assessment year. The updated return cannot be filed to report additional loss or decrease in the tax liability. The tax is required to be paid before the filing of the updated tax return and the proof to that extent is required to be attached while filing the updated return.
As per the Budget memorandum, a new provision in section 139 of the I-T Act is being introduced for filing an updated return of income by any person, whether he has filed a return previously for the relevant assessment year, or not.
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Talking about the value of death – Daily Maverick
Posted: at 5:51 am
The Report of the Lancet Commission on the Value of Death, due for imminent release, is part of a series of publications featuring the collaborative work of a broad and diverse range of academic partners, writers, activists, and others, who investigate the worlds most urgent scientific, medical and global health concerns. Their aim is to assess a prevailing issue and provide recommendations that could change health policy or improve practice.
This particular report, subtitled Rebalancing and Revaluing Death and Dying: Bringing Death Back Into Life, is a timely, cogent and illuminating foray into an aspect of life that few seem to consider, despite it being the one thing that we have in common we, and everyone we know, will all die someday.
The Report on the Value of Death is arresting for several reasons, which benefit from a nuanced understanding of what professor emeritus at Arizona State University and author Robert Kastenbaum has termed death systems. These are the means by which death and dying are understood, regulated and managed, which Kastenbaum first described as interpersonal, socio-physical and symbolic networks through which an individuals relationship to mortality is mediated by society.
These systems are complex, multidimensional and mutable, not easily changed, and shaped by spectrum of cultural, religious, spiritual, political and legislative practices, which implicitly or explicitly determine where people die, how dying people and their families should behave, how bodies are disposed of, how people mourn, and what death means for that culture or community. (The report limits itself to death and dying, and does not examine what happens to the dead.)
Society and the medical world have considered black lives cheap.
Death systems, the authors point out, are not benign. An afterword by Mpho Tutu van Furth, a South African Anglican priest, author and activist who has lived in the US, provides a corrective to the predominantly white, wealthy and Western perspective that embeds itself in much of the reports narrative, which the commission is self-consciously aware of.
Writing from her own perspective and not on behalf of two-thirds of the worlds population who do not enjoy access to healthcare, she attests to her own experience as a black South African woman and mother to two African American children, picking apart the cultural anomalies she witnessed growing up and going some distance further.
I saw the white flight from ageing and death, she writes. Black people had no illusion we could escape death. Black South Africans did not desire immortality. In death we would be gathered with our ancestors. Going home to our forebears was considered the reward for a life well lived.
This, however, takes place in the context of malevolent racism, both in South Africa and the US. Society and the medical world, she writes, have considered black lives cheap. She squarely accuses racism as a determinant of deaths value, saying that to ascribe the correct value to death we must assign the right price to every life, and provides the example of how Covid has disproportionately affected and afflicted black people everywhere.
Initiated before the current pandemic, the report nevertheless situates itself here, yet looks to the future.
Interestingly, it presents evidence that our collective experience of death during Covid has further fuelled the fear of death, instead of the opposite. Daily death tallies and statistics have not normalised death or brought it closer, but spurred further abstraction. Supporting this claim, the report draws attention to the extreme medicalised death (for some) that Covid has provided: death that has occurred in the forbidden province of a sealed hospital, staffed by masked and muffled and often stressed personnel, with limited communication between family members. Weve had more death, but moved it even further away.
The authors note: The increased number of deaths in hospital means that ever fewer people have witnessed or managed a death at home. This lack of experience and confidence causes a positive feedback loop which reinforces a dependence on institutional care of the dying.
Medical culture, fear of litigation, and financial incentives contribute to overtreatment at the end of life, further fuelling institutional deaths and the sense that professionals must manage death. Social customs influence the conversations in clinics and in intensive care units, often maintaining the tradition of not discussing death openly. More undiscussed deaths in institutions behind closed doors further reduce social familiarity with and understanding of death and dying.
Death is essential Without it, every birth would be a tragedy and civilisation would be unsustainable.
This experience, reinforcing the pervasive idea of healthcare services as the legitimate and proper custodian of death, is a trend initiated generations ago for a bevy of reasons. The authors relay that over the past 70 years, the shifting role of family, community, professionals, institutions, the state, and religion has meant that healthcare is now the main context in which many encounter death.
A natural death, in this paradigm, is simply considered as the cessation of medical support, and, according to the social critic Ivan Illich, dying has become the ultimate form of consumer resistance. (Similarly, the co-founder of the Death Caf movement, the late Jon Underwood, found a strong parallel between death denial and consumer capitalism. We buy stuff to perpetuate the idea of immortality through ownership, to feel alive, imagining that possessions confer meaning to life. Yet even if they last, we dont.)
The responsibility of healthcare, commonly understood as the prolonging of life and avoidance of death, therefore regards death itself as a failure. At the heart of the report is an urgent and radical proposal that we unpick and redetermine what medicine should do, and revalue death, recognising that it is not only normal and natural, but valuable, and has much to teach and bestow on us. After all, we were designed to die. We are a part of nature, as the pandemic has reminded us. Death is essential, the authors write. Without it, every birth would be a tragedy and civilisation would be unsustainable.
In rediscovering the intrinsic value of death, lost in the attrition of community skills and experience in care for our dying, and the concurrent emergence of life-saving medical technologies and the outsourcing of death, we are now urged to bring death closer, to talk about it and recognise that it provides an opportunity to build and maintain the relationships that sustain life itself.
In losing death, we lose life.
That death has become rarefied, obscured, mystified and hidden is a core problem, entrenching an imbalance that the recommendations of the report attempt to address in practical terms. The commission (which is how the authors refer to themselves, continually incorporating new members and ideas and inviting participation at every turn) is essentially concerned with the different ways we die, and proposes that death, dying and grief provide an acute lens not just into different death systems but into structural inequality and power dynamics which need urgent attention and change.
For example, women are disproportionately affected by death, and are typically seen as caregivers for the afflicted and dying, spending at least 2.5 times more time than men in unpaid care and domestic work. (In my own group of death doulas and end-of-life carers, for example, I am the only person who identifies as a man in a group of 40 women.)
In addition, widows are routinely stigmatised, in both rich and poor contexts, and commonly denied access to property or assets after the death of a spouse, whose existence often defines their own, and sometimes forced into degrading post-marriage rituals (treated as common family property) or shunned from employment or society. In middle- and high-income environments too, widowhood presents difficult social barriers and loss of status, income and life chances.
We are continually reminded in many examples in this report that the impact of race, class, gender, sexuality, socioeconomic status, or other forms of discrimination on mortality rates, access to care, or the incidence of diseases or conditions, is well established. Indeed, inequality is emphatically expressed in the perverse finding that those who receive the most care often dont need it, while those who need it the most dont get it. Poor people usually experience poor death. The relatively well-off may attempt some form of inoculation via medical care, but this too tends to have an often poor result. Death could clearly be better for everyone. The authors contend that most conditions for a good death could be offered to most dying people, without costly medical infrastructure or specialised knowledge.
At the heart of this paradoxical imbalance, the report locates the prevalence of overtreatment at the end of life as a particularly pernicious and often damaging practice and one which consumes a massive proportion of healthcare budgets the world over.
A startling finding is that in the last month of a persons life, whether in a resource-rich or poor context, a stupendous spike in costs usually occurs, frequently bankrupting surviving family despite having no positive benefit to the dying, and often increasing suffering.
But perhaps this is old news for people whove found themselves in this situation, unable to delimit potentially life-extending treatment, which doesnt necessarily improve the quality of life at all, for fear of being held accountable for death, or hastening it, and going against the grain of the medical impetus to prolong. In my own experience, I recall the glee conveyed by a daughter and her terminally ill mother who had together decided to abandon the crippling costs of another round of pointless chemotherapy and go on a final road trip together instead.
Medicines remit to extend life isnt appropriate where there is no realistic prospect of influencing lifes quality. While the palliative care movement is fortunately making strong if uneven advances for limiting pain at the end of life, and building models of holistic, integrated and team-based care that includes families to provide support that focuses on improving lifes quality in balance with deaths inevitability, far too many people die of common conditions that could be treated, and with no pain relief.
The World Health Organization reports that only 14% of people needing palliative care receive it. (This is the focus of a separate Lancet Commission report but is frequently referred to here.)
The report, drawing from a deep well of research (all of which is available on the commissions website) presents fascinating evidence of the frequency of hope and bias as causes of overtreatment, further entrenching the medicalisation of death. Hope, they posit, can encourage confirmation bias, where the subconscious selection of information usually accords with a desired outcome to stay alive. This racket is often run in collusion with afflicted individuals, their worried families and healthcare professionals alike. Bias similarly expresses itself in treatments recommended with little chance of success, even at any cost.
For example, in a study of 1,193 patients with late-stage cancer, 60% and 80% respectively of those with lung cancer and colorectal cancer receiving palliative chemotherapy expected the treatment to cure their illness despite the treatment not intended to be curative. Doctors, meanwhile, routinely show bias in their assessment of the likelihood of curative treatment. Better conversations need to happen, that recognise and are free of fear.
Perhaps this is unsurprising in a system where relationships and networks are replaced with professionals and protocols. In Cape Town, I recently listened to an esteemed city official describe ways to optimise death chain management during the pandemic. Psycho-spiritual support and home-based community care were off the radar.
Of several discrete yet overlapping sections in the report, the chapter on advanced life directives is particularly convincing as evidence that a positive shift in our death systems can be achieved through a reorganisation of relationships, without much expense.
Considering the level of end-of-life you deem appropriate (such as no insertion of artificial feeding tubes) can form part of a healthy communication between family members, and provide a binding template for your instructions when you may no longer be able to convey them, especially to medical staff. This, the authors suggest, should not be regarded as a difficult conversation, but recast as an essential one. (Readers might find some assistance here)
It seems like we have lost the ability to talk about death, as though talking about it is morbid, even fatal We can perhaps embrace the idea that talking about death is good for life.
The report suggests that this conversation is seen as a process rather than an event, and draws from Atul Gawandes seminal book, Being Mortal, to help frame this. In the context of illness, he asks: What is your understanding of where you are and of your illness? What are your fears or worries for the future? What are your goals and priorities? What outcomes are acceptable to you? What are you willing to sacrifice and not? And later, what would a good day look like?
The consequences of not having these conversations are severe. Having them, on the other hand, can limit suffering and provide pathways to healthy grief and loss that is less complicated than it might be. It seems like we have lost the ability to talk about death, as though talking about it is morbid, even fatal.
The death doula movement, the palliative care movement and other cultural projects promoting awareness of death, such as Death Cafs and the death positive movement, are changing this. These have, argues the sociologist Lyn Lofland, even heralded the age of thanatological chic. Perhaps this is necessary. For a rebalancing and revaluing of death, the report suggests, entails the active promotion of death literacy, which is something we can all learn. Evidence suggests, the report says, that talking collectively about these issues can lead to an improvement in peoples attitudes and capabilities for dealing with death. We can perhaps embrace the idea that talking about death is good for life.
This requires more change. The report mentions that until relatively recently, just two generations ago, most children would have witnessed a dead body. Now however, it is deemed some kind of aberration to have seen a corpse, as something remarkable and untoward, even unnatural. Many people in mid-life have never laid their eyes on the lifeless remains of a former co-traveller. We have become alienated from death, treating it as something to be avoided. Indeed, a plethora of scientific, technological, social and even religious endeavours reveal, in their quest for immortality, a possible anxiety that life is somehow insufficient and lacking. This impulse to escape mortal confines raises some profound philosophical, ethical and practical questions, not least of which is a question about access and further inequality. (Mpho Tutu van Furths earlier testimony regarding the welcoming return home in death for black Africans is a useful counterpoint, once again.)
Several of these initiatives are briefly described in the report, encompassing a quest to preserve life through anti-ageing techniques and a confabulation of associated technologies, the lasting idea of a magical elixir, uploading a digital mind and memories to the cloud, cryogenics, cloning, the egoistic impulse to create legacy, even the belief in an immortal soul forms part of this complex which, bluntly, is an aversion to physiological death and pulling away from the thing that is most essential to life our death. The Scottish-born former director of the Institute for the Future, Ian Morrison, is quoted here, joking that Scots see death as imminent. Canadians see death as inevitable. And Californians see death as optional.
Assisted dying, which is legal in Canada, receives broad examination in the report. As it seems likely to become more widespread, according to the authors, and is the subject of increasing debate worldwide, including South Africa, the report provides a refreshing summary of questions about assisted dying that demand further inquiry. These are proposed without the delimiting taint of an imposed morality, which often confounds consideration of this very germane topic.
A similarly dispassionate yet inspired gaze is deployed into consideration of five possible future scenarios for death and dying, as well as an extensive description of the remarkable paradigm shift in Kerala, India (population 35 million) where dying from a life-limiting disease is a social problem with medical aspects rather than the commonly held converse view.
The report concludes with a list of recommendations organised into various categories and the enumeration of the qualities required for what the authors describe as a realistic utopia, a desired model inspired by the Keralan example, and a way that each of us can work to change the death systems we inhabit.
Briefly, these qualities are: that the social determinants of death, dying, and grieving are tackled; that dying is understood to be a relational and spiritual process rather than simply a physiological event; that networks of care lead support for people dying, caring, and grieving; that conversations and stories about everyday death, dying, and grief become common; and perhaps most importantly, that death is recognised as having value.
Incredibly, even though death and dying are part of life an everyday part of life affecting us all, as we are continually exposed to the death of others and live with the certainty of our own mortality, indeed, are embroiled in the twin process of living and dying in every moment as we move from birth death is not only absent from many medical conversations, but social ones too.
This report encourages the fact that we clearly have much to talk about. Death is part of life, not something that happens at the end of it. Breaking the taboo about speaking about death feels transgressive and can be revelatory.
Revaluing death, as this remarkable report suggests, has the profound ability to make lives better. The philosopher Martin Heidegger, who examined our relationship with death and who is quoted in the report, reminds us that although we may apprehend the death of others, no one else can die my death for me. Acknowledgment and contemplation of this ineluctable fact free us to authentically become who we are and, hopefully, encourage us to take up the shared responsibility of affording the same value to the death, and life, of everyone who draws breath. DM/ML/MC
Sean OConnor is a death doula and hosts the How To Die podcast, at http://www.howtodie.co.za, currently in pre-production for a second season.
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