Antimicrobial use and misuse at the end of life: a retrospective analysis of a treatment escalation/limitation plan

Background Antimicrobial treatment is common at end of life. A treatment escalation/limitation plan (TELP) offers the opportunity to avoid non-beneficial treatment in critically ill patients. Our aim was to evaluate antimicrobial prescribing in terminally ill patients, and assess whether it was modified using a TELP.

Vex not his ghost: King Lear and end-of-life care

King Lear is not limited to a single ethical dilemma but is a play about the suffering of mankind. This paper investigates how elements of Shakespeare’s play might enrich our understanding of the challenges and opportunities of modern end-of-life care. The paper addresses the following key questions:

• How can King Lear inform our understanding of suffering and pain in a clinical context?

• What can King Lear teach the professional in terms of communication with a terminally ill patient and their family?

Stockton-on-Tees symposium: Recent advances in medicine

This symposium provided an update on recent advances in medicine relevant to the general physician. The opening session on respiratory medicine session focused on lung cancer and lung transplantation. Everyday practical issues of dealing with abnormal liver function tests were considered in session two as well as the challenges in improving end-of-life care. Clinically orientated presentations in the third session covered case-based discussions on severe metabolic acidosis and the management of Parkinson’s disease.