Comment: Ethics for all – from enthusiasm to standards
Andrew Hoy
pp 38-38
The study of ethics by healthcare professionals has not always commanded high popularity ratings. On occasion in the past it seemed that ethical practice amounted to little more than avoiding improper intimacy with patients, being careful not to upset referral systems and avoiding quacks and charlatans. Popular journalism in the last few years has changed all that. Complementary therapy, advance directives, informed consent, patients’ charters, euthanasia and equity of access to new expensive treatments are all topics for which the lay public has developed an insatiable appetite.
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Nutritional issues in advanced cancer
Jane Power
pp 39-42
There are many side-effects of advanced cancer that can affect an individual’s nutritional intake, such as anorexia, bowel obstruction and dysphagia. These can be very distressing for both the patient and carers. The amount of food and fluid taken is often seen by the family as an indication of the patient’s overall condition. It is expected that people with cancer lose weight, and this is perceived as a visible sign of progressive disease.
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The role of the volunteer in British palliative care
Barbara Whitewood
pp 44-47
The volunteers are an integral part of British palliative care, whether they are working directly with patients and their families, or giving other essential support, such as raising money. Volunteers do not take the place of staff, but work alongside them in a complementary way. In January 1999, there was a total of 236 specialist palliative care inpatient services using volunteers in the UK. Sixty-one of these are managed by the National Health Service, including 19 children’s hospices. The units are situated in inner city, urban and rural areas – each has its own dilemmas.
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Ethics and the transversality of hospital palliative care teams
Dominique Abry, Joëlle Chevalier, Fabienne Durand, Guillemette Laval, Brigitte Lelut and Paul Pavan
pp 48-52
The Unité de Recherche et de Soutien en Soins Palliatifs , the Hospital Palliative Care Team (HPCT) at the Grenoble Teaching Hospital supports the fixed clinical departments when palliative care is required, and also fulfils a research role. Its main duty is to give other departments advice when it requires palliative care support.
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Culture and ethnicity
David Oliviere
pp 53-56
It is impossible to understand a patient without understanding his or her culture and ethnicity. This article describes the concepts of culture and ethnicity and emphasises their importance within the total care model of palliative care. It addresses the practice issues that relate particularly to culture and ethnicity and summarises the areas of service development and individual care that need to be addressed in order to ensure a palliative care service that is sensitive to patients’ needs. Finally, this paper discusses the reasons why cultural pain and cultural care are important as part of ‘total pain’ and ‘total care’ and examines the concept of cultural safety in palliative care.
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Dance and movement therapy
Rebecca Hanson
pp 57-59
The Education Department of the Royal Opera House (ROH) has taken artists into hospices to perform small concerts for a number of years. Recently, the ROH has visited two hospices where Leah-Marian Jones (Principal, The Royal Opera) sang arias from The Barber of Seville and Carmen, Robert Clark (musician) played piano pieces by Chopin and Debussy, while Jenny Tattersall and Tom Whitehead (Royal Ballet Artists) performed a specially commissioned piece for ‘unusual spaces’. The performances were choreographed by Cathy Marston to the first movement of Pergolesi’s Stabat Mater and were followed by an informal ‘meet the artists’ session.
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The Poznan Declaration 1998
pp 61-63
This declaration was initially made by the participants in the 9th Palliative Medicine Advanced Course held in Poznan, Poland, 25–29 May 1998. It was jointly organised by the Palliative Care Department of the University of Medical Sciences, Poznan, and Sir Michael Sobell House, Oxford, UK, a World Health Organisation (WHO) collaborating centre for palliative cancer care. The course was jointly sponsored by the Polish Ministry of Health and the Stefan Batory Foundation of Warsaw. During the course, special workshops chaired by Ian Stjernswärd and Jacek Luczak were held on cancer pain relief and palliative care in eastern Europe. From the discussions at those workshops, this declaration emerged.
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Meeting report: 9th Palliative Care Advanced Course Puszczykowo near Poznan, Poland 24–29 May 1998
Jacek Luczak
pp 63-65
The annual courses in Puszczykowo involve palliative care professionals from the East and West exchanging experiences. As usual, this year’s course was organised by the Palliative Care Department of Karol Marcinkowski University of Medical Sciences, Poznan, Poland, in cooperation with Sir Michael Sobell House, Oxford, UK, under the direction of Professor Jacek Luczak (Director of the Department in Poznan), Dr Michael Minton (Medical Director of Sir Michael Sobell House) and Dr Zbigniew Zylicz (Medical Director of Hospice Rosenheuvel, Rosendaal, Holland).
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