Comment: Mortality, metaphors and the media
Marilyn Marks
pp 200-200
As I write, Great Britain is still enjoying the warm glow of success after the Olympic Games in Sydney. On the field, track and water, heroic struggles and great battles were undertaken every day as sporting heroes and heroines pursued personal and national glory. In the same month, the 5th International Conference on Death, Dying and Disposal took place in London. Two papers were of particular relevance. Clive Seale analysed the endless metaphors in today’s press reports about individual cancer patients, looking at both military and sporting metaphors and religious vocabulary. Lynn McLaughlan examined press announcements of deaths, and noted the rigidity of language used.
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Analgesic use in patients with renal failure
Alison Farrell and Alison Rich
pp 201-205
Current interest in palliative care for patients who do not have a cancer diagnosis is increasing. Palliative care, as defined by the World Health Authority, is the active total care of a person whose condition is no longer responsive to curative therapy. This is mirrespective of age or diagnosis and not just during the final days or weeks of life. Patients with a diagnosis of both acute and chronic renal failure may have palliative care needs. The mortality rate for patients with acute renal failure is about 40%.
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Cancer pain syndromes
Mellar Davis and Declan Walsh
pp 206-209
Pain assessment requires not only evaluation of intensity but also determination of pathophysiology. Recognised cancer pain syndromes, and pain patterns, are associated with a particular tumour location. A constellation of associated factors including speed of onset, palliative factors, quality, location, radiation and amplifying factors are elicited by history. This identifies these syndromes and will lead to an appropriate radiographic evaluation and effective pain control. Most pain is tumour-related and most patients have multiple pains, each of which requires a separate history.
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Artificial hydration and nutrition at the end of life
Susie Ede
pp 210-212
There is an abundance of information about terminal dehydration, but, to date, little quantifiable research on the physiological effects of dehydration in the last few days of life1 due to the ethical difficulties of conducting such research. The dictionary definition of dehydration is ‘excessive loss of water from the body or from an organ bodily part’. Mosby’s medical and nursing dictionary describes dehydration as loss of water from the body tissues, which may cause electrolyte disturbances, and other symptoms, such as compromised skin integrity.
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Can patients’ relatives justify colluding with healthcare staff?
Ian Trueman
pp 213-217
For centuries philosophers have attempted to answer the fundamental questions about our existence and challenge values for which no argument has been offered. Philosophy has been defined as ‘the use of reason and argument in seeking truth and knowledge of reality’. Ethics, deriving from the Greek word ethikos, is a branch of philosophy which examines the character and conduct of people. Morals are the Latin equivalent of ethics and tend to be used in the same context. Therefore morals relate to standards of behaviour and ethics is the study of those morals.
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Can we talk of quality of life just before death?
Gérard Poussin, Maria-Caterina Manes-Gallo, Robert Monti, Chrystel le Quang, Guillermo Jasso-Mosqueda and Françoise Guyot
pp 218-220
Is there any point in finding out about the quality of life of patients who are about to die? Is there any point in it for them or for their carers? Is it not outrageous to use the concept of ‘quality of life’ in such a context? Or is it, on the contrary, important to get to the bottom of this point on which the whole problematical aspect of palliative care actually hinges?
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Understanding children's pain through drawinga
Christina Liossi
pp 222-225
Much has been written about the nature and treatment of acute pain in the paediatric cancer population but the syndrome of chronic pain has received little attention until recently. This neglect has been due, at least in part, to the nature of pain and the difficulties inherent in assessing and measuring it. These difficulties are confounded by the child’s limited verbal ability in describing pain. Children’s cancer pain is a complex, multidimensional phenomenon with sensory, affective, cognitive, spiritual and interpersonal components.
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Group music therapy for young bereaved teenagers
Katrina McFerran-Skewes and Denise Erdonmez-Grocke
pp 227-229
Working with bereaved teenagers can be a daunting experience for professional caregivers, as the psychosocial stage of adolescence demands the rejection of adult authority in order to develop individual morals and belief systems. In addition, younger teenagers may display greater care-eliciting behaviours because they lack the experience to communicate the intense emotions of grief in other ways. Music therapy groups can offer teenagers the opportunity to explore their grief through non-confronting and creative methods. By sharing their experience within a self-contained therapy group, young people can acquire the wisdom resulting from successfully coping with grief.
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The 7th EAPC Congress in the heart of Palermo
Sebastiano Mercadante
pp 231-230
It all started in Aarhus. Quite typical of all my transfers from Palermo, I arrived in the Danish town of Aarhus after three or four connections to give a speech at the International Association for the Study of Pain (IASP) national congress. My colleague Giorgio Trizzino had come with me to Aarhus. He was on holiday and was as usual making himself comfortable in my hotel room.
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