BACKGROUND In this single-site study, we evaluated the feasibility of a parent-clinician communication intervention designed to: identify parents' rationale for the phase I, do-not-resuscitate (DNR), or terminal care decision made on behalf of their child with incurable cancer; identify their definition of being a good parent to their ill child; and provide this information to the child's clini...

A family clinic providing specialist paediatric and adult medical, testing, counselling, and terminal care services for families living with HIV was set up at a paediatric tertiary care hospital in London in 1991. During the first five years, until April 1996, 185 children from 149 families attended, including 119 infected children, of whom 32 have died. Only 5% of mothers were born in the UK; ...

degree of Master of Science in Miedical Statistics. London: London School of Hygince and Iropical Medicine, 1988. 51 pp (MSc report. ) 10 Rickford F. The decision every wornatn drcads. Living Mfagazine 1988;Sep: 54-7. 11 Anderson R. 'he unremitting burdcn oncarers. BrMled] 1987;294:73. 12 Levin F, Sinclair I, (iorach 1'. I'he supporters of confused elderly persons at home. In: Families, servitc...

Progress in medical diagnosis and therapy has raised new problems with far-reaching ethical implications. Medicine must remain a profession and not become a business. Textbooks must address ethical problems in the context of health care decisions and not restrict themselves to pathophysiology and practical therapeutics alone. The relative roles of the principles of autonomy, non-maleficence, be...

Current trends in population ageing show that, in the near future, while more people will live longer, more will also die at any one time. Health systems, as well as individual practitioners, are only just becoming aware of the extent of this problem. Health systems will have to rapidly change practice to manage the number of people dying in the coming years, many with complex multimorbid condi...

A seventy-eight-year-old married woman with progressive Alzheimer’s disease was admitted to a local hospital with pneumonia and other medical problems. She was able to recognize no one, and she had been incontinent for about a year. Despite aggressive treatment, the pneumonia failed to resolve, and it seemed increasingly likely that this admission was to be for terminal care. The patient’s husb...

BACKGROUND Cancer prevalence-the proportion of people in a population with a diagnosis of cancer-includes groups with widely differing cancer care needs. We estimated the proportions of the prevalent colon cancer cases requiring initial care, terminal care and follow-up. PATIENTS AND METHODS Prevalence by year since diagnosis was estimated from incidence and vital status data on 243,471 colon...

This article describes how epidemiology may be used effectively to provide hard statistical data upon which to justify and base the development of paediatric palliative nursing services within a defined locality. Through an analysis of mortality data this study identified the number of children and young people with life-limited (LL) conditions who met the criteria for paediatric palliative car...

In Japan, there are no acts and, specific provisions or official guidelines on euthanasia, but recently, as I will mention below, an official guideline on "death with dignity" has been made. Nevertheless in fact, this guideline provides only a few rules of process on terminal care. Therefore the problems of euthanasia and "death with dignity" are mainly left to the legal interpretation by liter...

Palliative care is an approach that improves quality of life for patients and their families facing problems associated with a life-threatening illness. Care planning is particularly important in CF, where predicting a time of death is extremely difficult. The patient and family should receive realistic information about health status and further options of care. Particularly important is the e...