Obstetrics and gynecology
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Obstetrics and gynecology · Jul 1990
The quality of dying: financial, psychological, and ethical dilemmas.
The quality of life of terminally ill patients depends on the information base and psychosocial skills of their health care team. Patients have the right to choose to forego medical care, and it is important to learn the who, what, when, and where of informing a patient and supporting their decisions. ⋯ The impoverishment of the family, monetarily and physically; the denial of alternatives, even though potentially more cost-effective; and lack of coverage for a significant portion of the patient population can make humane care at the end of life impossible. Physicians have an ethical responsibility to inform themselves about terminal care and to advocate improved coverage at the end of life.
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Obstetrics and gynecology · Jul 1990
History of physical and sexual abuse in women with chronic pelvic pain.
The history of physical and sexual abuse in childhood and adulthood was assessed in 31 women with chronic pelvic pain, 142 women with chronic pain in other locations, and 32 controls. Thirty-nine percent of patients with chronic pelvic pain had been physically abused in childhood. ⋯ Abuse in adulthood was less common and was not significantly more likely to have occurred in patients with chronic pelvic pain than in other chronic-pain patients or controls. These data suggest that pelvic pain is unlikely to be specifically and psychodynamically related to sexual abuse but that the pernicious nature of abuse, whether physical or sexual, may promote the chronicity of painful conditions.