Group work with bereaved children
Jean Baulkwill and Christine Wood
pp 113-115
After the death of a parent, children and their siblings can be faced with almost total emotional isolation. In addition to the emptiness following the death, the grief of the surviving parent often presents an overwhelming barrier that prevents the children from sharing their own feelings and anxieties.
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Pathophysiology of osteolysis: the putative mode of action of bisphosphonates
Jean-Jacques Body
pp 116-120
The skeleton is the most common site of metastases in breast and prostate cancers and is the most frequent site of first recurrence. More than 50% of patients with metastatic breast cancer will develop bone metastases during the course of their disease. Patients with bone metastatic involvement have a longer survival than patients with extra-osseous metastases only.
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Prognostic factors in terminal cancer patients
Marco Maltoni, Marco Pirovano, Oriana Nanni, Roberto Labianca and Dino Amadori
pp 122-125
A solid tumour that is too advanced to be removed by surgery and/or with metastases is defined as being at an ‘advanced stage’. Usually, solid tumours diagnosed as at an advanced stage will merit no curative treatment. Certain tumours, however (eg, Hodgkin’s lymphoma, high-grade non-Hodgkin’s lymphomas, testicular cancer), can be cured, even if diagnosed at an advanced or metastatic stage. For some other tumours (eg, ovarian cancer, small cell lung cancer), survival following anticancer treatment can be prolonged to such an extent that some advanced stage patients can be considered cured.
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Palliative Cancer Care Guidelines in Scotland
John Berkeley
pp 126-127
In recent years a wide variety of terms have been used to define quality in health care – policies, parameters, algorithms and branching standards. So what are ‘Palliative Cancer Care Guidelines’ and what are they for? The Clinical Resource and Audit Group (CRAG) of the Home and Health Department of the Scottish Office defines clinical guidelines as ‘systematically developed statements which assist in decision making about appropriate health care for specific clinical conditions’.
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The Scottish Guidelines
Michèle Salamagne
pp 128-128
Guidelines on palliative care therapy in oncology have been produced with the support of the Scottish Partnership Agency for Palliative and Cancer Care (SPAPCC) and the collaboration of the Clinical Resource and Audit Group (CRAG).
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A mobile palliative care team
Jean-Michel Lassaunière
pp 130-131
Mobile palliative care teams are made up of volunteer professionals, trained to provide the necessary care for patients at the advanced stages of a serious illness. They come under the control of a hospital or home-nursing team and help them to improve the quality of care. The first mobile team in Europe was set up in 1977 at St Thomas’s Hospital in London.
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Interdisciplinary activity in a mobile palliative care team
Danielle Roisin, Guillemette Laval and Brigitte Lelut
pp 132-135
The concepts of multidisciplinary and interdisciplinary work have not yet been thoroughly explored in our relationship with patients. The multidisciplinary combinination of different but complementary professional abilities may already be present in teams working with patients approaching the end of life. The interdisciplinary approach is a very special partnership that is often difficult to put into practice. This article aims to emphasise the wealth of this resource as well as its demands, and to give carers some practical guidelines.
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Psychosocial support and therapy in cancer care
James Brennan and Tim Sheard
pp 136-139
Cancer care is changing rapidly. In the UK it has, for the most part, been organised by doctors, with a heavy emphasis on the treatment of tumours. This focus has been widened by the development of the new medical and nursing specialty of palliative medicine, in response to the growth of the hospice movement within the voluntary sector.
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Attitudes of healthcare professionals towards euthanasia
Giorgio Di Mola
pp 140-144
Although the euthanasia debate is now raging, it is often conducted solely in terms of arguments ‘for’ or ‘against’, ‘prolegislation’ or ‘anti-legislation’, while the sociocultural, psychological and anthropological aspects, for example, are disregarded. Nor should we neglect the discussion about whether euthanasia is a problem concerning society as a whole or an exclusively medical matter. However, there is no consensus yet on what it is that justifies or condemns the conduct of a person who commits an act of mercy-killing.
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Conclusions on euthanasia
Fiona Randall
pp 146-147
The report of the Select Committee of the House of Lords on medical ethics, published in February 1994, comprises a detailed and comprehensive survey of the written and oral evidence the Committee received from individuals, lay and professional associations, together with the resulting opinion of the Committee, and contains well-argued reasons for reaching the unanimous conclusions and recommendations described.
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The hospice of the future
Franco De Conno
pp 148-149
A competition held by the University of Milan’s faculty of architecture to encourage the design of a hospice building or bed/armchair for terminally ill patients stimulated such a high standard of entry that ten winners will receive prizes at the award ceremony in September this year.
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