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Cicely SaundersSelected Writings 1958-2004$
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Cicely Saunders

Print publication date: 2006

Print ISBN-13: 9780198570530

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780198570530.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 28 October 2021

Current Views on Pain Relief and Terminal Care

Current Views on Pain Relief and Terminal Care

First published in The Therapy of Pain (1981), ed. M. Swerdlow, pp. 215–41. Lancaster: MTP Press.

(p.163) 25 Current Views on Pain Relief and Terminal Care
Cicely Saunders

Cicely Saunders

Oxford University Press

This chapter begins with the observation that ‘the use of the word terminal has tended to obscure the fact that it does not always refer to an irreversible state’. Terminal care is seen as a facet of oncology, being concerned with the control of symptoms of the disease process once that process has become uncontrollable. The chapter includes sections on the nature of terminal pain, its assessment and analysis, referral to other disciplines, the use of analgesics in pain prevention, absorption of oral narcotics, the last hours, the choice of opiate, and the Brompton Mixture. There are also sections on mental pain, social pain, spiritual pain, and staff pain. The paper establishes morphine as the preferred analgesic to diamorphine and also notes that following the research of Twycross, Melzack, and others, the use of mixtures containing alcohol and cocaine should be discontinued.

Keywords:   analgesics, oral narcotics, morphine, last hours, Brompton Mixture, mental pain, spiritual pain, social pain, staff pain

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