Improving Palliative Care

Abstract

Although most deaths in the United States occur in hospitals, data suggest that hospitals and physicians are not equipped to handle the medical and psychosocial problems of dying patients. In this article, we review the barriers to achieving a peaceful death, including inadequate medical professional education on palliative care, and public and professional uncertainty about the difference between foregoing life-sustaining treatment and active euthanasia, and health professionals' difficulty recognizing when patients are dying and the associated sense that death is a professional failure. Other barriers include fiscal constraints on the length of stay, the number of nurses available to care for dying patients, legal and regulatory constraints on obtaining opioid prescriptions, and a segregated system of hospice care that requires patients to be separated from familiar health care providers and settings in order to receive palliative care at the end of life. Identifying the opportunities that can improve the delivery of palliative care at the end of life is the first step toward developing corrective approaches. Strategies that enhance these opportunities are proposed.

Determination of cannabinoids in hemp food products by use of headspace solid-phase microextraction and gas chromatography?mass spectrometry

“…Positive drug tests for marijuana use have been reported after ingestion of hempseed oil [5,6,7,8,9,10] and other hemp foods [11,12]. Intoxication has also been reported [13]. Since the mid 1990s, hemp food has gradually expanded into the natural product market and is increasingly found in natural food stores sold for nutritional and health benefits [14,15].…”

A rapid and simple procedure for the determination of cannabinoids in hemp food products by gas chromatography-mass spectrometry

“…For this reason, Switzerland and Germany established maximum legal limits for the THC concentration in different foods [6]. Furthermore, it is worth noting that a positive result to drug tests for marijuana use have been observed after ingestion of hempseed oil and other hemp foods, with the risk of producing a positive result in workplace drug testing [7][8]. Over the last 2 years, different types of hemp food gradually spread into the Italian natural foods stores and have been sold for "supposed" nutritional and health benefits.…”

Consensus guidelines on analgesia and sedation in dying intensive care unit patients

“…If they administer too little to control distress, they provide inadequate palliative care and patients suffer [1-7]. If they administer too much for life to continue, they may risk prosecution for committing euthanasia [6,8-15].…”