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BMJ 2006;332:647-648 (18 March), doi:10.1136/bmj.332.7542.647
Dawn E Davies, assistant professor1
1 Department of Paediatrics, University of Alberta, 11402 University Avenue, Edmonton, AB, Canada T6G 2J3 dawn.davies@ualberta.ca
| The first 150 words of the full text of this article appear below. |
Doctors prescribe opioids and other controlled drugs to make patients in a variety of states of disease more comfortable. Once in the community, these drugs are not monitored or audited, and patients and their families are responsible for handling them safely. Recently, end of life care has received greater international attention, and the field of palliative care is emerging strongly. This, in turn, has often changed the setting in which palliative care services are provided from hospital to home. The two cases that follow show a potential hazard in the current system.
A boy with congenital rhabdoid tumour of the face received palliative care at home for progressive disease. The tumour grew to involve almost half of his face, with inferomedial displacement of his palate. He presented with pain seven weeks before his death. Initially the pain was controlled with codeine and simple analgesics, but it eventually intensified. He was
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