Articles: palliative-care.
-
The problems related to requests for euthanasia by terminal patients; the variations in attitude of palliative care physicians and the possibility that availability of the best palliative care might obviate the problem by eliminating requests for euthanasia, are under discussion. ⋯ The attitudes of physicians practising palliative care in Italy are not different from those reported by previous studies which investigated the attitude of other health professionals. There was no agreement about whether the best palliative care might reduce requests for euthanasia by terminal patients.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Epidural and subcutaneous morphine in the management of cancer pain: a double-blind cross-over study.
Ten patients who suffered from severe cancer-related pain participated in a randomised, double-blind and cross-over study to compare the effectiveness and acceptability of epidural and subcutaneous administration of morphine. The patients titrated themselves pain-free in 48 h using a patient controlled analgesia system. ⋯ The two modes of morphine administration turned out to be comparable in terms of both effectiveness and acceptability. Both treatments provided better pain relief with less adverse effects compared with the prestudy oral morphine treatment.
-
J Pain Symptom Manage · Oct 1996
ReviewThe ethics of death-hastening or death-causing palliative analgesic administration to the terminally ill.
Double-effect reasoning is a nonconsequentialist analysis of a hard ethical case. In a hard ethical case, one can achieve some good end only if one also causes harm. Sometimes palliative analgesic administration to a terminally ill patient is a hard ethical case, for by it one relieves pain or distress while unavoidably hastening or causing the patient's death. Is it ethically in the clear to administer an analgesic to relieve pain or distress knowing that one will hasten or cause the patient's death? Using double-effect reasoning, the author argues that death-hastening or death-causing palliative analgesic administration to a terminally ill patient is sometimes ethically in the clear and, at times, even obligatory.
-
Jt Comm J Qual Improv · Oct 1996
Cancer pain management: pilot implementation of the AHCPR guideline in Utah.
Using the Agency for Health Care Policy and Research's (AHCPR's) 1994 Clinical Practice Guideline for Management of Cancer Pain, HealthInsight, the peer review organization for Utah and Nevada, organized a cooperative project with physicians and nurses from seven acute care hospitals in Utah. The project's purpose was to adapt the guideline into action plans for participating hospitals and provide the tools necessary to address six "core" guidelines-to assess and relieve pain, educate the patient/family and health care workers, measure patient satisfaction, and provide a continuum of care postdischarge. GUIDELINE DEVELOPMENT: The guidelines were further adapted to meet the needs of the individual hospitals and were implemented in January 1995. Baseline data was collected on 10 patient records per hospital. ⋯ The project team continues to monitor progress in guideline implementation. Surveys demonstrate that, at the time of diagnosis, up to 45% of cancer patients experience moderate to severe pain; 65%-90% experience severe pain when cancer reaches the advanced stages. Unrelieved cancer pain can cause intense suffering, diminished activity, loss of appetite, and loss of sleep.