European Journal of Palliative Care - 2017

Dame Glenis Willmott, MEP, explains why it is imperative for the future of UK participation in cross-border clinical trials that the UK government incorporates the new EU Clinical Trials Regulation in the EU Withdrawal Bill so that it becomes UK law.

David Clark and Sandy Whitelaw outline their vision for a new type of ‘care campus’ that would provide an environment in which older people, ranging from those able to live with complete independence to those with palliative care needs, would become part of the community of The Crichton Campus in Dumfries.

Stefanie Küttner, Ann Christina Foldenauer, Johannes Wüller and Tania Pastrana carried out a study inquiring into whether palliative care patients under the care of one team felt that their psychological distress would be relieved if they received further professional support.

In her winning entry for The Royal Society of Medicine’s Palliative Care Section’s George Adams Prize for a medical student essay, Lucy Taylor looks at the future of palliative care and considers how its values can be brought into medical practice as a whole and more widely promulgated within communities.

The links between oral healthcare and various aspects of general health in children and adults have been well established for some time. Susan Fowler-Kerry, Marcella Ogenchuk and Caprice Knapp make the case for those delivering paediatric palliative care to make regular oral healthcare, as received by healthy children, a standard part of their care, and for nursing research on the oral health needs of children requiring palliative care.

The fifth article in our series ‘Psychology in palliative practice’ looks at the concept of ‘denial’, a term whose meaning has evolved since its original application in the psychological sense by Freud. Once meaning a total rejection of reality, denial now encompasses a range of situations frequently encountered in patients receiving palliative care. But these patients are not usually denying the reality of their condition – rather, they are using various mechanisms, including disavowal and dual thinking, as coping strategies. Jenny Strachan explains how these strategies work and advises on how palliative care professionals can work with these patients effectively.

As cancer treatments continue to allow patients to live with cancer for longer, and patients get access to palliative care services at an earlier stage in their condition, the complexity of cases is likely to increase. Clare Statham and Paul Perkins argue the need for randomised controlled trials to enable guidance to be produced on the management of ascites in hospices.

Joanna Davies, Derek Willis and Rob George examine the philosophical principle known as the double effect. Part II looks at the practical applications of the theory in a palliative care setting. Part I, which covered theoretical aspects, appeared in issue 24(4). The illogical association between the double effect, opioid therapy and palliative care is understandable in non-medics, and it will not be easy to turn around society’s entrenched attitudes towards opioids as being dangerous. This situation is not being helped by the opioid crisis in the USA and Canada, which links opioids – that in fact have been over-prescribed in those countries – to addiction and substitution with heroin.

Those involved in a sponsored clinical trial in Sue Ryder Leckhampton Court Hospice, and those involved in an inspection of that trial – Anne Parkinson, Mandy Budwal-Jagait, Andy Fisher, Gabriel Fox, Julie Hapeshi and Paul Perkins – recount the experience and advise on the procedures to be followed by all parties.

The 2017 Researcher Awards of the European Association for Palliative Care (EAPC) were presented in May at the 15th EAPC World Congress in Madrid, Spain, to Lara Pivodic, Miguel Julião and Irene Tuffrey-Wijne. Here the winners reflect on their careers so far and tell us how they feel about being recognised in this way by the international palliative care community.