SURGICAL PALLIATIVE CARE
Geoffrey P. Dunn and Alan G. Johnson (Eds)
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Oxford University Press, 2004
267pp
ISBN 019-851000-4
RRP $US75 £49.9
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The stereotypical surgeon is portrayed as the expert technician, the ‘captain of the ship’, acting decisively, unrelenting in the
fight against disease. To do otherwise would be to allow the patient no hope and constitute abandonment of care. Well, welcome to the 21st century, this book is about the appropriate integration
of surgical skills into the comprehensive management of patients with advanced disease.
The first part of the book includes chapters on ethics and surgical decision-making in the context of advanced disease, and there
are good discussions on spirituality, interdisciplinary care and quality of life. The second part reviews surgical interventions that may be of benefit to palliative care patients, although orthopaedic
surgery seems to have been left out.
This pioneering book is a most welcome first step towards educating the surgical community about the broader aspects of patient-centered
care. It clearly outlines how the surgeon can usefully participate in the team management of patients with advanced disease, and underlines the need for the surgeon to have a sympathetic understanding
of the nonsurgical aspects of care, including psychosocial and spiritual suffering. But will surgeons read it? Some won’t, and they will remain stereotyped. Others will, and may discover a new
dimension to the care they can offer their patients. The goal is not to turn surgeons into palliative care specialists, but knowing the basics of how to deal with patients with advanced disease
and their families (patient-centered holistic care, good communication, working effectively in an interdisciplinary team, grief and bereavement skills, etc) should be as much a part of surgical
training as learning to tie knots.
Roger Woodruff
Director of Palliative Care, Austin Health, Melbourne, Australia
May 2004
Author Information
Dr. Geoffrey Dunn is Attending Surgeon, Department of Surgery, Hamot Medical Centre, and Medical Director, Great Lakes Hospice, Erie,
USA and
Chair of Surgeon’s Palliative Care Workgroup
http://www.promotingexcellence.org/surgeons/index.html
Dr. Alan Johnson is Emeritus Professor of Surgery, University of Sheffield, UK.
Table of Contents
Part 1
Introduction - is surgical palliative care a paradox?
Dunn
Selection and preparation of patients for surgical palliation
Easson & Ng:
The ethics of interventional care
Angelos
The physiological response to surgical trauma
Barber & Fearon
The psychological response to surgery
Stevens
Spirituality & surgery
Ravenscroft & Ravenscroft:
Interdisciplinary care
Mosenthal, Price & Murphy
Quality of life issues in palliative surgery
Koller, Nies & Lorenz
Anaesthesia and peri-operative pain management
Simpson & Bush:
Part 2
Symptom palliation of diseases of the head and neck (includingdentistry)
Rogers
The surgical relief of the symptomatic chest
Nelems
Surgery for the control of symptoms in the abdomen
Johnson
Symptom control in urological malignancy
Doherty & O'Sullivan:
Wound and reconstructive problems in advanced disease
Krizek
Neurosurgical palliation
Johnson
The role of the ophthalmologist in advanced disease
Yorsten
Perspectives from the developing world and diverse societies
Aluwihare
Epilogue: a message to all surgeons
Dunn & Johnson
Index
