European Journal of Palliative Care - 1997

Intractable pain in the terminally ill
Guillemette Laval, Danielle Roisin and René Schaerer
pp 43-48
Intractable pain in palliative medicine and terminal care is a harsh reality for everyone concerned – patient, carers and relatives. Great efforts are needed to counteract its alienating effect, described by Cicely Saunders as ‘a total pain that gradually overwhelms the patient’s consciousness, cutting them off from other people’.

Lymphorrhoea in palliative care
Julie Ling, Alison Duncan, Diane Laverty and Janet Hardy
pp 50-52
Lymphorrhoea has been defined as the leakage of lymph through a break in the skin, either as a result of trauma or onset or exacerbation of oedema when the skin is not able to stretch quickly enough to accommodate swelling.

Pain as an ethical and religious problem
Salvino Leone
pp 54-57
If we ask children ‘What is pain?’ most answer: ‘Something that hurts’. Of course, if we bear in mind the golden rule of ethics, do good and avoid evil, every ‘hurting thing’ must be suppressed. But this conflicts with many ethical and anthropological issues, making the duty to care and the methods of pain suppression less clear-cut. An even more difficult problem is the highly subjective nature of pain itself – every ‘objective’ consideration is therefore always rather questionable.

Towards a definition of suffering
Susan Salt
pp 58-60
To cure sometimes, to relieve often, to comfort always’. ‘Suffering’ is a word we encounter frequently and is at the core of all we do as palliative care professionals. But do we really know what it means? By trying to define ‘suffering’ we are forced to think about how we might respond.

Breaking bad news and the challenge of communication
Alison Franks
pp 61-65
‘Breaking bad news’ is not a new topic, nor is it confined to medical situations. However, despite decades of discussions, criticisms and literature, it continues to be badly done. It can be a potential cause of anxiety for healthcare professionals and frequently a source of distress, dissatisfaction and complaint from the public.

January/February 1997, Volume 4 Number 1