European Journal of Palliative Care - 1998

The management of cerebral metastases
Annette Edwards and Georgina Gerrard
pp 7-11
Cerebral metastases are present in 15–40% of patients with systemic cancer and are an important cause of morbidity and mortality. The three most common primary sites are lung, breast and melanoma. In autopsy series, approximately 60% of all patients with small cell lung cancer4 and 75% of patients who die of metastatic melanoma5 have demonstrable brain metastases. If these remain untreated, the median survival is about one month; this is possibly extended to two months by treatment with corticosteroids. After cranial irradiation the median survival period is 3–6 months.

The treatment of morphineinduced constipation
Nigel Sykes
pp 12-15
Constipation is one of the most troublesome adverse effects of morphine analgesia. Opioid-induced constipation cannot always be adequately controlled with conventional laxatives. Patients may therefore not accept the morphine doses that they need to control their pain.

Quality of life for all
Baroness Jay
pp 16-17
The fact that the 5th European Congress is so well attended is a fitting tribute to the growing stature of palliative care across Europe. The Congress provides an important opportunity for those involved in palliative care in Europe to come together to listen and learn from each other. The UK is honoured to host this occasion.

Organ donation in palliative care
David Feuer
pp 21-25
There is a high level of knowledge about the role of organ transplantation in the UK, with about 90% of the UK population being aware of the procedure. Although most (70%) are in favour of organ transplantation, a relative few (30%) carry organ donor cards.

Spanish rules governing prescription of opioids
Jose F Olalla
pp 26-26
The new rules on the prescription of narcotics were issued in Spain in May 1994 and came into force 60 days later. The new legislation answered the concerns of health professionals dealing with pain control and several consumer groups. Many difficulties and drawbacks had to be overcome before the rules were published in the Spanish Official Gazette. The old, established legislation (issued in 1935) had become customary practice.

Palliative care and the euthanasia debate in Australia
Margaret O’Connor
pp 27-31
The Rights of the Terminally Ill Act passed in Australia in mid-1995 meant that the Northern Territory (six states and two territories make up the whole of Australia) became the first place in the world to legalise voluntary euthanasia. This is distinct from the Netherlands, where euthanasia has been decriminalised.