The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Mar 2004
ReviewDying with dignity: the good patient versus the good death.
Death is a unique experience for each human being, yet there is tremendous societal pressure on a dying person to be a "goodpatient " while trying to experience the "good death. " These pressures shape patient, caregiver, and family choices in end-of-life situations. The purpose of this literature review was twofold: first, to develop an understanding of "dying with dignity" to enhance the end-of-life care received by dying patients, and second, to contribute to a concept analysis of dignity to improve the clarity and consistency of future research related to dignity in aging individuals. ⋯ The definition of dignity in dying identifies not only an intrinsic, unconditional quality of human worth, but also the external qualities of physical comfort, autonomy, meaningfulness, usefulness, preparedness, and interpersonal connection. For many elderly individuals, death is a process, rather than a moment in time, resting on a need for balance between the technology of science and the transcendence of spirituality.
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Am J Hosp Palliat Care · Mar 2004
Review Case ReportsThe conversion challenge: from intrathecal to oral morphine.
Numerous articles have described the methodologies used and outcomes achieved with the intrathecal (IT) administration of morphine for pain. However, only one case report has been published that describes converting a patient's IT morphine to an oral regimen. ⋯ This is substantially lower than the 300:1 ratio published by Krames and the 90:1 ratio employed by a commercially available software program for calculating equianalgesic opioid doses. We recommend caution when applying existing guidelines for conversion of morphine from an IT to an oral regimen.