Tuesday, September 27, 2005

Lancet--end of life perspectives series continues with the Catholic view. Virulent C. diff may be emerging.

The current Lancet continues its end of life perspectives series with the Catholic view .  There is a general section on withholding treatment but the piece as a whole avoids the recent controversies about artificial nutrition & hydration, the Papal allocution, etc.  Actually the article as a whole I found quite well written & meditative & expressing beautifully--despite my areligious tendencies--what I love about medicine & palliative care:
     "According to Pellegrino and Thomasma, the sense of finitude, vulnerability, loss of self, and destruction of a person's normal life that is experienced in illness can be transformed when a sacramental approach to medicine is taken. They note that the art of medicine is a human endeavour that imitates the beauty and creativity of God. In experiencing this art, the patient experiences transcendence rather than despair. In this way finitude is transformed. When physicians treat patients regardless of how the patient might have contributed to their own illness, and when they respond to the cry of the patient for help, vulnerability is overcome. When an attempt is made to treat the whole person, rather than focusing on bodily functions, personhood is restored. Finally, when the focus of medicine is to place the patient, even though he or she may be dying, back into the community where he or she has the opportunity to experience the love of those around him or her, the sense of disruption of life is attended to. All these components of healing function as signs of God's grace."

There's also a brief article about an emerging epidemic strain of C. difficile in Quebec which appears to produce toxins A & B in quantities an order of magnitude higher than normal.  This could drastically effect our patients' lives.

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