Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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From superstition and witchcraft, to detailed scientific insight into the human body in health and disease: Stupendous though the development of medical science has been over the last few centuries, it does not in itself give doctors a sufficient basis for meeting their patients and the people around them. In these interpersonal encounters, fundamental, immaterial values are the all-important basis. These values and their place in life are not visible in science itself, hence the humanities and the arts offer approaches and inspiration that are of the greatest value in the education of doctors at all levels.
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At the Karolinska Institute, Stockholm's medical university, a new academic discipline was established in 1998. Humanistic medicine, or medical humanities, is a response to the need in an increasing technological medicine for a humanistic dimension in medical education and clinical practice. ⋯ At the Karolinska Institute, the discipline has three aspects: medical history, philosophy of medical science, and the "medical meeting", i.e. issues such as: What happens in the relation between patient and caregiver? What is the art of medicine? How is suffering and disease expressed in art and literature? Medical humanities can be a tool for critical reexamination and a radical reorientation of the ethos of medicine. After all, health care is at its very core a moral project.
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Tidsskr. Nor. Laegeforen. · Nov 2000
Case Reports[Non-convulsive status epilepticus--confusion and cognitive failure during seizures].
Non-convulsive status epilepticus is characterized by confusion and impaired consciousness, lasting at least half an hour. Seizure activity in the EEG confirms the diagnosis, but ictal discharges can be heterogeneous and difficult to classify. There is controversy regarding evidence of morbidity in humans. ⋯ Complex partial status epilepticus of frontal origin is common, but differentiation between complex partial and generalised non-convulsive status can be difficult. The clinical symptoms may overlap, and generalised EEG seizure activity does not exclude initial focal ictal discharges. Presumably the reported sequelae after this condition are in most cases a consequence of underlying cerebral illness. Treatment response to diazepam can be variable, with high recurrence risk. Effective prophylactic treatment is most important.
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Developing high-quality patient-centred palliative care involving different professions in a local health care situation is a challenging task. It is difficult to establish co-operation on the allocation of resources to individual patients throughout the phases of disease. There are financial constraints, but also incongruities between the various levels of the health care system. Doctors' participation in cancer care is hidden in various tasks, and the contribution of GPs can be difficult to grasp. Patient-centred cancer care requires local co-operation; the intention in public health policy is to let the GP and the primary care nurse provide continuity of care, with the GP in the role of co-ordinator and organiser. ⋯ There is a sizeable potential for quality improvement in local palliative cancer care and in the vertical and horizontal communication between the professional groups involved.