What's new for 'palliative care in general medical journals' in pubmed

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1: BMJ. 2007 Mar 17;334(7593):555. Related Articles, LinkOut

Two thousand health staff sign petition calling for euthanasia to be decriminalised.

Spurgeon B.

Publication Types:

News

PMID: 17363802 [PubMed - indexed for MEDLINE]

2: CMAJ. 2007 Mar 13;176(6):762-3. Related Articles, LinkOut

Interventional radiology in palliative care.

Baerlocher MO, Asch MR.

Radiology Residency Training Program, University of Toronto, Toronto, Ont.

Publication Types:

Case Reports

PMID: 17353527 [PubMed - indexed for MEDLINE]

3: BMJ. 2007 Mar 10;334(7592):511-3. Related Articles, LinkOut: Getting services right for those sick enough to die.

Dy S, Lynn J.

Johns Hopkins University, Room 609, 624 North Broadway, Baltimore, MD 21205, USA. sdy@jhsph.edu

PMID: 17347238 [PubMed - indexed for MEDLINE]

4: BMJ. 2007 Mar 10;334(7592):485-6. Related Articles, LinkOut

Comment on:

BMJ. 2007 Mar 10;334(7592):521.

Researching a good death.

Workman S.

Publication Types:

Comment
Editorial

PMID: 17347190 [PubMed - indexed for MEDLINE]

5: BMJ. 2007 Mar 10;334(7592):521. Epub 2007 Feb 28. Related Articles, Cited Articles, Free in PMC, LinkOut

Comment in:

BMJ. 2007 Mar 10;334(7592):485-6.

Key challenges and ways forward in researching the "good death": qualitative in-depth interview and focus group study.

Kendall M, Harris F, Boyd K, Sheikh A, Murray SA, Brown D, Mallinson I, Kearney N, Worth A.

Primary Palliative Care Research Group, Division of Community Health Sciences: General Practice Section, University of Edinburgh, EH8 9DX. Marilyn.Kendall@ed.ac.uk

OBJECTIVE: To understand key challenges in researching end of life issues and identify ways of overcoming these. DESIGN: Qualitative study involving in-depth interviews with researchers and focus groups with people affected by cancer. PARTICIPANTS: An international sample of 32 researchers; seven patients with experience of cancer; and four carers in south east Scotland. RESULTS: Researchers highlighted the difficulty of defining the end of life, overprotective gatekeeping by ethics committees and clinical staff, the need to factor in high attrition rates associated with deterioration or death, and managing the emotions of participants and research staff. People affected by cancer and researchers suggested that many people nearing the end of life do want to be offered the chance to participate in research, provided it is conducted sensitively. Although such research can be demanding, most researchers believed it to be no more problematic than many other areas of research and that the challenges identified can be overcome. CONCLUSIONS: The continuing taboos around death and dying act as barriers to the commissioning and conduct of end of life research. Some people facing death, however, may want to participate in research and should be allowed to do so. Ethics committees and clinical staff must balance understandable concern about non-maleficence with the right of people with advanced illness to participate in research. Despite the inherent difficulties, end of life research can be conducted with ethical and methodological rigour. Adequate psychological support must be provided for participants, researchers, and transcribers.

Publication Types:

Research Support, Non-U.S. Gov't

PMID: 17329313 [PubMed - indexed for MEDLINE]

6: Postgrad Med J. 2007 Feb;83(976):137-40. Related Articles, LinkOut

An audit of "do not attempt resuscitation" decisions in two district general hospitals: do current guidelines need changing?

Harris D, Davies R.

Nevill Hall Hospital, Abergavenny, South Wales, 15 Llwyn Y Grant Terrace, Penylan, Cardiff CF23 9EW, UK. dgharris@doctors.org.uk

INTRODUCTION: Doctors in all specialties are involved in making "do not attempt resuscitation" (DNAR) decisions; this can be a difficult and challenging process. Guidelines exist to provide an ethical and legal framework for the process and documentation of these decisions. OBJECTIVE: To audit the documentation of resuscitation decisions in a sample of medical inpatients from two district general hospitals. Method: A retrospective case note audit of 50 medical inpatients, in which a DNAR decision had been made (28 from hospital 1, 22 from hospital 2). RESULTS: Average age was 78.9 years (48% male:52% female). In both hospitals DNAR decisions were usually discussed with relatives (84%), documented in nursing notes (100%) and made by senior team members (90%). Although the decision was usually dated and clearly documented (98%), abbreviations were commonly used in hospital 2 (45.5% vs 0% in hospital 1, p<0.05). Decisions regarding other treatment were not consistently documented (78.6% and 72.7%, respectively) and there was little evidence that decisions were reviewed (14.3% and 31.8%). The decision was rarely discussed with the patient (6% of all patients), although 66% of patients were not in a position to have a discussion. CONCLUSIONS: Specific forms for recording DNAR decisions improve the clarity of documentation. Current recommendations to discuss resuscitation with patients are controversial and not followed. However, many patients are not in a position to hold a discussion when the need arises and the guidelines should advocate early discussion during a hospital admission in patients where this is appropriate, prior discussion with family and/or wider use of advanced directives.

Publication Types:

Multicenter Study

PMID: 17308220 [PubMed - indexed for MEDLINE]