- Title Pages
- Disclaimer
- Acknowledgements
- Introduction
- 1 Dying of Cancer
- 2 Should a Patient Know … ?
- 3 When a Patient is Dying
- 4 The Management of Patients in the Terminal Stage
- 5 And From Sudden Death…
- 6 A Patient
- 7 the Care of the Dying
- 8 Terminal Illness
- 9 Working at St. Joseph's Hospice Hackney
- 10 The Treatment of Intractable Pain In Terminal Cancer
- 11 Distress in Dying
- 12 The Depths and the Possible Heights
- 13 The Need for Institutional Care for the Patient with Advanced Cancer
- 14 the Last Stages of Life
- 15 the Last Frontier
- 16 The Management of Terminal Illness
- 17 St. Christopher's Hospice
- 18 Training for the Practice of Clinical Gerontology: The Role of Social Medicine
- 19 A Place to Die
- 20 Dimensions of Death
- 21 The Problem of Euthanasia (Care of the Dying—1)
- 22 Appropriate Treatment, Appropriate Death
- 23 The Philosophy of Terminal Care
- 24 Templeton Prize Speech
- 25 Current Views on Pain Relief and Terminal Care
- 26 Heroin and Morphine In Advanced Cancer
- 27 Pain and Impending Death
- 28 On Dying Well
- 29 Evaluation of Hospice Activities
- 30 The Modern Hospice
- 31 Foreword (<i>Pain: an Exploration</i>)
- 32 Spiritual Pain
- 33 Hospice—a Meeting Place for Religion and Science
- 34 Letter (On Alfred Worcester)
- 35 Voluntary Euthanasia
- 36 Foreword (<i>Mortally Wounded:Stories of Soul Pain, Death, and Healing</i>)
- 37 Why I Welcome TV Cameras at the Death Bed
- 38 Foreword (Good Practices In Palliative Care: A Psychosocial Perspective)
- 39 Origins: International Perspectives, Then and Now
- 40 the Evolution of Palliative Care
- 41 A Voice for the Voiceless
- 42 The Evolution of Palliative Care
- 43 Foreword (Oxford Textbook of Palliative Medicine)
- 44 Introduction (<i>Management of Advanced Disease</i>)
- Index
Heroin and Morphine In Advanced Cancer
Heroin and Morphine In Advanced Cancer
First published as a letter in The New England Journal of Medicine, vol. 310, no. 9 (1984), p. 599.
- Chapter:
- (p.183) 26 Heroin and Morphine In Advanced Cancer
- Source:
- Cicely Saunders
- Author(s):
Cicely Saunders
- Publisher:
- Oxford University Press
This chapter presents a short letter, co-authored with Thomas Walsh, and which appeared in the New England Journal of Medicine in 1984. The background to the letter was a growing lobby within the United States in support of the legalisation of the use of diamorphine for pain relief within medical practice. Although the drug is licensed for use in the UK and is prescribed for use at St Christopher's, the authors take the view that there is no case for legalisation in America or elsewhere, and that such debates indeed detract from the more important issue of overall improvement in the care of patients nearing the end of life — with whatever armamentarium is available in a given setting.
Keywords: diamorphine, legalisation, terminal patients, Thomas Walsh, America
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- Title Pages
- Disclaimer
- Acknowledgements
- Introduction
- 1 Dying of Cancer
- 2 Should a Patient Know … ?
- 3 When a Patient is Dying
- 4 The Management of Patients in the Terminal Stage
- 5 And From Sudden Death…
- 6 A Patient
- 7 the Care of the Dying
- 8 Terminal Illness
- 9 Working at St. Joseph's Hospice Hackney
- 10 The Treatment of Intractable Pain In Terminal Cancer
- 11 Distress in Dying
- 12 The Depths and the Possible Heights
- 13 The Need for Institutional Care for the Patient with Advanced Cancer
- 14 the Last Stages of Life
- 15 the Last Frontier
- 16 The Management of Terminal Illness
- 17 St. Christopher's Hospice
- 18 Training for the Practice of Clinical Gerontology: The Role of Social Medicine
- 19 A Place to Die
- 20 Dimensions of Death
- 21 The Problem of Euthanasia (Care of the Dying—1)
- 22 Appropriate Treatment, Appropriate Death
- 23 The Philosophy of Terminal Care
- 24 Templeton Prize Speech
- 25 Current Views on Pain Relief and Terminal Care
- 26 Heroin and Morphine In Advanced Cancer
- 27 Pain and Impending Death
- 28 On Dying Well
- 29 Evaluation of Hospice Activities
- 30 The Modern Hospice
- 31 Foreword (<i>Pain: an Exploration</i>)
- 32 Spiritual Pain
- 33 Hospice—a Meeting Place for Religion and Science
- 34 Letter (On Alfred Worcester)
- 35 Voluntary Euthanasia
- 36 Foreword (<i>Mortally Wounded:Stories of Soul Pain, Death, and Healing</i>)
- 37 Why I Welcome TV Cameras at the Death Bed
- 38 Foreword (Good Practices In Palliative Care: A Psychosocial Perspective)
- 39 Origins: International Perspectives, Then and Now
- 40 the Evolution of Palliative Care
- 41 A Voice for the Voiceless
- 42 The Evolution of Palliative Care
- 43 Foreword (Oxford Textbook of Palliative Medicine)
- 44 Introduction (<i>Management of Advanced Disease</i>)
- Index