Comment: One voice – one vision
Stein Kaasa
pp 48-48
The EAPC, with its primary goal of developing and disseminating palliative care at a scientific, clinical and social level, is more important within Europe than ever before. Population distribution in the developing world is evolving towards a higher proportion of elderly people, while at the same time, new developments in medicine have improved survival for many patients, without necessarily improving cure rates. Consequently, a greater number of people will be in need of palliative care.
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Anaemia and blood transfusions in palliative care
Susan Salt
pp 49-53
Anaemia is a common problem in patients with advanced, progressive life threatening illnesses. The cause of anaemia is often multifactorial, which makes the decision about how, and when, to treat it particularly difficult. This is compounded by concerns about the safety of blood transfusions and the risk of serious injury and death if errors are made in their administration. There is increasing evidence that there might be a role for alternative treatments using recombinant erythropoietin in some circumstances in palliative care.
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Oral candidosis: how to treat a common problem
Jeremy Bagg
pp 54-56
Oral candidosis in the form of ‘oral thrush’ has been recognised for hundreds of years and is often described as a ‘disease of the diseased’. Therefore, not surprisingly, oral fungal infections are a common problem among patients receiving palliative care for advanced cancer.
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Case study masterclass 8: Is palliative care always helpful?
Carol Davis and Val Lewington
pp 58-59
George is a 43-year-old occupational therapist, who used to work at the local hospital, often alongside the hospital palliative care team.
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Case study masterclass 7 answers: Complications of a rare tumour
Carol Davis and Val Lewington
pp 59-59
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Infection control in hospices
Pauline Dand
pp 60-62
Infection control in healthcare is aimed at managing the healthcare environment to minimise the risks of infection to patients and staff. This is usually achieved through the development of policies and guidelines relevant to the healthcare setting, monitoring hygiene procedures, carrying out surveillance of infections, and providing advice and education to staff.
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Euthanasia and physicianassisted suicide: a view from an EAPC Ethics Task Force
The EAPC Ethics Task Force on palliative care and euthanasia
pp 63-66
In 1991, a debate at the European Parliament on euthanasia stimulated discussion at all levels in Europe. Subsequently, the Board of Directors of the EAPC organised a working session together with two experts to help them clarify the position the organisation should adopt towards euthanasia. The experts collaborated with the Board of Directors on a document and in 1994 the EAPC produced a first statement, Regarding euthanasia, published in the official journal of the EAPC – the European Journal of Palliative Care . In February 2001, the EAPC Board asked an expert group to form an Ethics Task Force to review the subject and advise the organisation accordingly.
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Research on attitudes towards euthanasia in terminally ill patients
Juan M Núñez Olarte
pp 68-71
Agrowing number of researchers have recently focused on attitudes and desires related to euthanasia and physician assisted suicide (PAS) in terminally ill patients. The information provided by these types of studies should, and probably will, become essential for the debate in this contentious area. Research performed requesting opinions from seriously (but not terminally) ill patients, carers, physicians and other healthcare professionals, and the general population is certainly important, but should be considered ‘proxy’ evidence when trying to assess the attitudes and desires of patients facing imminent death. Nevertheless, and in order to be relevant, research on opinions on euthanasia and PAS in terminally ill patients should be performed in such a way that present methodological limitations and ethical concerns might be addressed with cultural sensitivity.
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The development of palliative care in St Petersburg, Russia
Michael Wright and David Clark
pp 72-75
From the 1980s, life expectancy in the Russian Federation (population 146.5 million) has declined and mortality rates have increased. At present, around 60% more people are dying than are being born, a rise in mortality unprecedented in a 20th-century industrialised nation. During 2000, around 297,000 deaths were from cancer – 203.1 per 100,000 people. Compared with western countries, the cancer rate among those over the age of 65 is fairly low, although cancer-related mortality in the 0–64 age group is among the highest in Eastern Europe and the Commonwealth of Independent States.
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Suffering – a problem that also affects nurses
Marie-Fleur Bernard and Françoise Creux
pp 77-81
Working in an oncology or palliative care department – in places where one is constantly exposed to serious illness, disability and death and brought into direct contact with suffering – makes nurses question the sense in their duties and tasks, but perhaps more significantly, the sense in human existence and sometimes even in their own life. This aspect of their work impacts nurses’ health.
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