Comment: Assisted suicide has no place in medical care Ilora Finlay pp 161-161 Repeated surveys of British doctors have shown that the majority are opposed to the legalisation of ‘assisted dying’, the latest euphemism for physician-assisted suicide (PAS). The general public appears to support PAS, although even its support wanes to equal numbers for and against when the facts are made clear. Only one in five doctors would be personally prepared to participate actively in causing a patient’s death. Among those who support legislative change in theory, over one third would not want to participate in practice.
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How to manage persistent or intractable hiccups in the absence of solid evidence Deirdre Finnerty and Fiona Kiely pp 162-164 Although uncommon, hiccups can have an adverse effect on patients’ quality of life. Deirdre Finnerty and Fiona Kiely have looked at the literature to see how hiccups are managed in palliative care. They highlight the available options, but also the lack of a strong evidence base, for the treatment of persistent and intractable hiccups.
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A UK hospice plays host to a local network of people involved in dementia care Michael Tapley, Ann Regan and David Jolle pp 165-168 In Tameside and Glossop, since May 2014, professionals involved in dementia care meet every two months over a cup of tea at the initiative of Willow Wood Hospice. Michael Tapley, Ann Regan and David Jolley explain the idea behind this informal network.
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EJPC Palliative Care Policy Development Award: an interview with the 2015 winner, Emilio Herrera Emilio Herrera pp 169-171 Spanish palliative care physician Emilio Herrera received this year’s EJPC Palliative Care Policy Development Award on 10 May 2015 at the 14th World Congress of the European Association for Palliative Care in Copenhagen. Passionate about relieving suffering, his way of contributing is by setting up innovative programmes and models of palliative care delivery. He tells us more about his efforts to transform healthcare systems.
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Case study masterclass 81: Improving the quality of life of an elderly man with prostate cancer and radiotherapy-induced diarrhoea Andrew M Davis pp 172-173 Robert is an 84-year-old retired mechanical engineer from Lanarkshire, Scotland. He lives in a bungalow in a post-industrial Scottish town with his wife Margaret, aged 79. They have two daughters, both of whom live locally, and a son who lives in New Zealand. They also have six grandchildren and three great-grandchildren. Five years ago Margaret had a stroke and she now has residual left-sided hemiplegia. Robert is Margaret’s main carer but despite this caring role, he has been able to maintain an active social life.
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Case study masterclass 80 answers: Addressing the needs of a 67-year-old woman with vulval cancer and ‘total pain’ Katherine Bevan pp 174-174
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A patient with Duchenne muscular dystrophy in transitional care who wishes to have a child Derek Willis, Caroline Hart and Tracey A Willis pp 175-177 Patients with conditions like Duchenne muscular dystrophy (DMD) are now living longer. Many young adults with these conditions are going through transitional care; they might well have wishes such as to be in a relationship or even start a family. Derek Willis, Caroline Hart and Tracey A Willis discuss the ethical considerations around the wish of an adult man with DMD to have a child.
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Facebook helps to get the palliative care message across to future doctors Leeroy William, Michael Edward Franco and Peter Poon pp 178-181 Can social media help improve people’s understanding and knowledge of palliative care? Leeroy William, Michael Edward Franco and Peter Poon from Australia believe so. In 2012, they created a Facebook page under the name ‘palliative medicine teaching’ as a way of reaching and engaging undergraduate medical students.
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Using a joint approach to non-invasive ventilation in motor neurone disease Imogen Nixon, Faustina Popkiewicz, Sandip Banerjee, Lisa Vincent-Smith and David Oliver pp 182-184 Imogen Nixon, Faustina Popkiewicz, Sandip Banerjee, Lisa Vincent-Smith and David Oliver have assessed how non-invasive ventilation (NIV) was used in patients with motor neurone disease in the Medway area. They found that most recommendations made by the National Institute for Health and Care Excellence had been met thanks to the adoption of a multidisciplinary approach.
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Bereavement care provision in Europe: a survey by the EAPC Bereavement Care Taskforce Mai-Britt Guldin, Irene Murphy, Orla Keegan, Barbara Monroe, Maria Antonia Lacasta Reverte and Inger Benkel pp 185-189 The Bereavement Care Taskforce of the EAPC has conducted a survey on bereavement care service provision in Europe. Mai-Britt Guldin, Irene Murphy, Orla Keegan, Barbara Monroe, Maria Antonia Lacasta Reverte and Inger Benkel report on the results. One of the key findings is that not all palliative care services seem to prioritise bereavement care as an integral part of their offer.
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‘First, do no harm’: a solution-focused approach to pain measurement and management Dominic Bray, Karen Groves, Jason Latham, Joanne Iddon and Emma Weymouth pp 190-193 Using pain scales can be counterproductive as it risks focusing patients’ attention on their pain, thus increasing it. Instead, the solution-focused approach advocated by Dominic Bray, Karen Groves, Jason Latham, Joanne Iddon and Emma Weymouth focuses on well-being and on what patients want to, and still can, achieve.
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Key performance indicators for palliative care social work: a pilot study from New South Wales, Australia Julie Garrard, Claudia Graham, Trish McKinnon and Brendan Myhill pp 194-197 The Palliative Care Social Work Interest Group in Sydney, Australia, is looking into setting key performance indicators (KPIs) for palliative care social work. Four of its members, Julie Garrard, Claudia Graham, Trish McKinnon and Brendan Myhill, explain the collaborative process adopted to conduct a preliminary study on the topic.
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Creating a regional, home-based outpatient palliative care service in Croatia Julijana Franinovic Markovic, Roberta Katacic, Sonja Grozic Živolic, Ante Ivancic, Diego Brumini and Bosiljka Kovacevic pp 198-201 In Croatia, there is still little organised palliative care service provision at national level. Julijana Franinovic Markovic, Roberta Katacic, Sonja Grozic Živolic, Ante Ivancic, Diego Brumini and Bosiljka Kovacevic describe how, in the last ten years, home-based outpatient services were created in the Istria County, in the north-west of Croatia.
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Palliative care in Cambodia: embryonic service provision and cultural barriers Sochinda Pav, Ruth Penfold and Jacqueline H Watts pp 202-204 Despite recent economic growth, Cambodia still has a fragile and poorly resourced health infrastructure and palliative care is in an embryonic state, according to Sochinda Pav, Ruth Penfold and Jacqueline H Watts, because of lack of funding and awareness but also because of cultural issues. However, there are signs that things might be changing.
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European insight: Palliative care in Flanders: from the pioneering 1980s to new challenges going towards 2020 Alexander Verstaen, Paul Vanden Berghe and Gert Huysmans pp 205-207 In 2010, Belgium was rated fifth best country worldwide regarding the ‘quality of death’. So has palliative care attained all its goals? Not quite. In Flanders, like in other parts of the country, many challenges remain. The Federation of Palliative Care Flanders tells us more.
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