1/105. The loss of Peyton. eclampsia, a convulsive disorder usually occurring near the end of pregnancy and more often than not occurring with primigravida mothers, represents a serious toxic condition that endangers the life of both the mother and child. Because of this possibility it is very important for women to receive prenatal care. Most obstetricians believe that the causes of eclampsia are unknown. However, midwives usually believe that good nutrition in combination with the reduction of stress prevents eclampsia. eclampsia can be insidious and can present itself with little warning. ( info) |
2/105. Thanatomania in an Asmat community. A report of successful "western" treatment. Case report from the Asmat-area, West New Guineaof black magic in a 12-year-old boy, confirmed anthropologically and medically. Successful treatment by western medicine was achieved by removing the emotional pressure exerted by the community on the patient through physical and pharmaceutical isoledical help saving a black magic victim. A follow-up of the medicine and anthropology, permitting a discussion of the medical cultural implication. ( info) |
3/105. pastoral care for perinatal and neonatal health care providers. health care workers in the perinatal and neonatal environments experience many emotions as they encounter stressors day after day. The chaplain, one of many on the multidisciplinary team, can serve as a valuable resource for other team members. This article provides an overview of the various supportive roles the chaplain can assume. A case presentation highlights pastoral care of staff and family across the continuum from the perinatal to the neonatal units. ( info) |
4/105. Assessment of need for a children's hospice program. Canuck Place, north america's first free-standing pediatric hospice of its kind, opened in 1995 in british columbia, canada. The province-wide program encompasses a broad spectrum of services intended to support community-based care and provide periodic, facility-based respite and palliative care to children with life-threatening, progressive illness and to their families. Loss and grief support is another integral component of the program. The concept of pediatric hospice care is founded on the premise that dying children and their families can benefit from care designed to maximize present quality of life; yet, the creation of such programs must be based on demonstrated need. One vital step in the development of the Canuck Place program was assessing the need for such a program within the province. Data from both traditional quantitative and less traditional qualitative sources were used to document and put forth an argument in support of developing a children's hospice program. The final report addressed several components that are summarized in this article for the purposes of assisting others who may wish to undertake similar projects in their own communities. ( info) |
5/105. Death in the home: the doctor's responsibility. The role physicians assume when patients die at home is nebulous and ill defined. Beyond the traditional function of providing comfort and condolence to family members, the physician's duties are directed toward how our society deals with the bureaucratic and legal aspects of death. statistics are maintained regarding the numbers of deaths in municipalities and states and the causes of death, and those numbers are used by individuals and organizations for a multitude of legal, medical, and political purposes. The state also has an obvious interest in uncovering and prosecuting crime. The physician has a vital part to play in providing essential medical information for those record-keeping, statistical, and legal purposes. physicians need to be mindful of the important functions being served when they are asked to complete death certificates and to report cases and provide information to the medical examiner. As with many other physician activities, the information we provide about our patients' deaths serves a singular societal need; thus, we should view that function not as a burden but as a vital aspect of the enriching and enobling work that is uniquely ours. ( info) |
6/105. Near death: a nurse reflects. After reading about near-death phenomena in the December issue, this nurse was inspired to share her own experience. Her story and observations may help you better understand and help patients who've been to the brink of death and back. ( info) |
7/105. To die young, to die old management of terminal illness at age 20 and at age 85: case reports. Death and dying in a 20-year-old woman. An effort was made to provide emotional support during the terminal phase of leukemia in a 20-year-old woman. Notable were the patient's own ways of coping and the responses of her family and the hospital staff. She first denied and then recognized her own dying. Her anger was prominent, and she withdrew from objects toward the end. The intense stresses in the doctor-patient relationship, transference, countertransference, and reality factors are described. ( info) |
8/105. injections and the fear of death: an essay on the limits of biomedicine among the Dagomba of northern ghana. This article offers a cultural ("indigenous") explanation of why people in their quest for therapy sometimes reject biomedicine. The argument is that in the current debate over the power of biomedicine, there is a lack of scrutiny of its "failures", i.e. of why people occasionally refuse to accept the offers of biomedicine and its most powerful therapy, injection-therapy. After introducing the problem, the relevant literature and the methods used, the article proceeds by first using historical material regarding vaccination campaigns and the treatment of endemic diseases in ghana and comparative data from elsewhere in africa to show that people may be ambivalent and have a mixed view of the power of biomedicine. In the context of their experiences, people (possibly, in particular, older ones) have come to know both the (early) failures as well as the successes of injection-therapy. Turning to the ethnographic present (1990-1997) the record of Dagomba notions of health and illness as well as two cases are analyzed to define this ambiguity also among younger members of Dagomba culture. Thus, the article oscillates between ethnography and history to define people's ambivalence and the conflict between biomedicine and local understandings. ( info) |
9/105. Clinical supervision, death, Heidegger and Freud come 'out of the sighs'. In his recent paper on clinical supervision, 'Out of the sighs' - an existential-phenomenological method of clinical supervision: the contribution to palliative care', in this journal, Jones weds psychoanalytical ideas with Heidegger's existential-phenomenological concepts to provide a theoretical framework for clinical supervision in palliative nursing. Although this is an interesting undertaking, theoretical diversity is not a simple matter of merely interchanging concepts. Rather, it is a complex process that must account for varying philosophical assumptions upon which any theory attempts to explain or understand reality. This paper examines the major themes identified by Jones. In particular, it focuses on the spirit of ontological hermeneutics and psychoanalysis, represented by their respective founders, Heidegger and Freud, and in general, refers to other thinkers and ideas mentioned by Jones - as for instance, Schon's reflective practice, Polanyi's personal commitment, Husserl's lived experience, Schutz's intersubjectivity and Yalom's existential disidentification. Here, discussion concerns the subject-object polarity. The paper argues that many of these philosophies are incompatible. In particular, psychoanalysis and existentialism imply inconsistent aims in that psychology does not equate with fundamental ontology - and Jones has not adequately distinguished between these in his supervision discourse. The implications of the accompanying conceptual problems for the practice of clinical supervision in palliative nursing are exemplified by Jones's case study of Lindsey, a dying patient. ( info) |
10/105. Is it ethical to practice intubations on the deceased? One-third to one-half of emergency departments in the united states and australia perform endotracheal intubations (ETI's) on the newly dead. Sixty-three percent of emergency medicine and 58% of neonatal critical care training programs allowed procedures to be performed on patients after death; only 10% of these programs required family consent for this practice. This article reviews the arguments for and against this ethical issue. A case study is included to highlight the issue's complexity, and to assist readers in identifying their beliefs (and those of their institutions) about the tissue. An overview of ethically related terms, definitions, and theories and a decision-making model are included to establish a knowledgeable baseline for dealing with any ethical issue. ( info) |