European palliative care in the longue durée
David Clark
pp 92-92
In a modern specialist field like palliative care, there is a tendency to take the shorter view of history. From this perspective, most true improvement is recent in origin yet radical in impact: today’s norms have overturned yesterday’s misconceptions and tomorrow always holds the promise of further scientific advancement. Medicine, in particular, can be a discipline uncomfortable with its past and irrepressibly forward-looking in orientation.
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Oxycodone: a review of the literature
Shamsul Shah and Janet Hardy
pp 93-96
Oral morphine has been designated by the World Health Organization (WHO) as the opioid of choice for the management of chronic cancer pain.1 In the majority of patients, cancer pain can be successfully managed with morphine. However, some patients experience dose-limiting sideeffects or have pain that is poorly responsive to morphine. It may, therefore, be appropriate to switch from morphine to an alternative opioid to improve the adverse effect profile and/or analgesia.
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Sedation and terminal care
Josep Porta Sales
pp 97-100
Terminal sedation is a common therapeutic procedure in palliative care which has recently caught the attention of several authors and investigation groups. This interest may be twofold; on the one hand there exists a disparity in the frequency of sedation reported in the literature and, on the other, the ethical point of view. In this paper, we present the results of a systematic literature review of studies published over the past ten years, concerning the clinical practice of terminal sedation in the hopes of shedding some light on the disparate information published on this topic.
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Ayurveda and palliative care
Henry Dom
pp 102-105
Until fairly recently, Ayurveda has been viewed in the West as an esoteric science which had little to offer as a complementary treatment to Western medicine or as an independent medical science. This position has changed as practitioners and users came to realise its universal application to each individual’s daily existence. Ayurveda means the ‘science of life’ or ‘the science of self-healing’ which speaks to every facet and element of human life, offering guidance to all those who seek greater harmony, peace and longevity.
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Support groups for children
Nicole Landry-Dattée and Marie France Delaigue-Cosset
pp 107-110
Young children and adolescents who have a parent suffering from cancer exhibit a high level of distress to a varying degree. Their parent’s illness creates in them a fear of loss. Both the symptoms of the disease and the effects of treatment change the daily routine and the roles of everyone in the family.Even parents who normally communicate well with their children, emphasise that they find it difficult to talk to them about a serious illness or death.
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Joint working, joint roles: streamlining patient care
Karen Chilver
pp 112-114
Ahigh profile has been given to the concepts of a seamless service and teamwork, and The new NHS – modern, dependable, but there is little information in the literature about the advantages and disadvantages of collaborative working and how this mode of working might be interpreted in practice. This article looks at how these concepts have been developed and at how they are working in Worcestershire.
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St Joseph’s Hospice: then and now
Yolande Saunders and Joy Ross
pp 115-118
The year 2000 was both a time for reflection and a time to look forward to new developments. At St Joseph’s Hospice in the East End of London, plans are in progress to rebuild the main palliative care wing, which currently houses three wards with a total of 63 beds. It seemed an opportune time to look back as well as forward, particularly as we have access to original archives and reports dating back to its inception in 1905 on the same site. The year 1907 was selected because this was the first year that a comprehensive report was produced. We wanted to know how and why it was set up, how many patients were treated, what sort of diseases they were suffering from, how the service was funded and whether there were any lessons that we could learn from the past and apply today. With these aims in mind we set about finding, reading and examining some of the archived material available at St Joseph’s.
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The role of the volunteer in the consultation process
Josiane Destable
pp 119-121
In the past in France, carers had only a little knowledge and a very restricted pharmacopoeia. A cure was rarely expected and left a lot to chance, but the carers were remarkably devoted in the attention and sympathy they gave to the suffering. Patients and families were resigned in the face of nature and destiny. Death was familiar and a part of life. Mainly rural families lived in a tribal fashion and communities stuck together to such an extent that there was always one person, if not several, attending the sick person.
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