PALLIATIVE CARE AND COMMUNICATION
Experiences in the Clinic
Anne-Mei The
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Open University Press, 2002
254 pp
ISBN 0-335-21205-0
RRP £24, $US30.95, $AU59.95
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This book is the result of a five-year ethnographic study in a Dutch clinic treating patients with small cell carcinoma of the lung.
It describes, in narrative form, the communication the patients received at the various stages of their illness trajectory. Each section has a complementary discussion of what was said (or not
said), how it was said, and what was understood. The important effects that each individual patient has on the results of doctor-patient communication are also discussed.
In her discussion of the overall study, Anne-Mei The makes many points which cause one to reflect on one’s own practices in communicating
bad news. The importance of allowing other health care professionals to be present at these discussions and not just the specialist cannot be underestimated, as it is these nurses and counselors
that will be looking after the patient and family after their few minutes with the doctor. She also raises even more fundamental questions about the validity of consent to treatment, and whether
patients with relapsed disease would not be better off spending less time at the hospital having chemotherapy, and more time attending to those matters that will improve the final phase of their
lives. Do patients suffer “somatization” and “medicalization” at the hands of specialist oncologists?
Although not written for the purpose, this book provides innumerable and compelling arguments in favor of comprehensive and coordinated
interdisciplinary supportive care for patients with incurable cancer. I found it thought-provoking and written in an engaging style.
Roger Woodruff,
Director of Palliative Care, Austin Health, Melbourne, Australia
June 2004
Author Information
Anne-Mei The is a senior researcher working at the Department of Social Medicine and Institute for Research in Extra Mural Medicine
at the VU University Medical Center and Project Leader of the COPZ Noord Nederland (Northern Netherlands Centre for Palliative Care).
Table of Contents
Introduction
Part I Bad news and choosing therapy
1. Patients
2. Doctors and Nurses
Part II Therapy, optimism and perseverance
3. The rising curve
4. Rescue therapy
5. Optimism and recovery
6. Reflection and anxiety
Part III Variations on a recurrence
7. Recurrence
8. Declining optimism
9. No therapy for Mr. Wessels
Part IV Parting
10. Breaking down optimism and ambivalence
11. The familiar hospital
12. Parting
Part V. Conclusion
13. Conclusions and recommendations
Bibliography
Index
