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Open University Press, 2004
ISBN 0-335-21243-3
791 pp
RRP £29.99, $US 42.95
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This new textbook aims to draw together the principles and evidence that underpin palliative care nursing. It is organized in a novel
fashion, following the trajectory of the illness, rather than the traditional physical, psychological, social and spiritual approach. The book is divided into four parts – Encountering illness,
Transitions into the terminal phase, Loss and bereavement, and Contemporary issues, the last covering nursing education, research and practice. Each Part is prefaced by an editorial Overview
that provides useful orientation, but the twenty pages spent listing what the authors say in the chapters that follow seemed unnecessary.
This book focuses on those facing death and emphasizes the nurses’ role in their care. There are some excellent chapters on access
to palliative care, dealing with families, grief and bereavement and other topics. Some other chapters I found a little long-winded. There are also issues where the clinical evidence base has
been overlooked. For example, in the two separate discussions on artificial hydration for the dying, the theories are presented but no reference made to the observational studies, never mind
the randomized control trial, which suggest it is of no benefit.
The discussion on euthanasia is disappointing. The author describes a “conceptual mist”, which I found to be a blinding smog. [John
Keown’s ‘Euthanasia’, recently reviewed here, provides an erudite and crystal-clear description]. There is repeated reference to Kuhse’s work that has been publicly discredited (incidentally,
by the authors of two other chapters in this book), and very little discussion of what the Dutch and Oregonians have shown us. Only on page 14, in the final paragraph, is it noted that some Dutch
patients were euthanased without request or consent. But as these cases fall outside the Dutch laws, they don’t warrant discussion. And the numbers of patients involved is “marginal”. A thousand
patients a year? Please!
My quibbles aside, this is a very impressive book that provides in-depth discussions on a range of issues that are less fully addressed
in other palliative care books. It will be of great value to nurses practising palliative care or studying it at a postgraduate level. For me, it was a little too long on theory and short on
clinical facts, so it complements but does not replace the “treatment manual” type of book. And we need both.
Roger Woodruff,
Director of Palliative Care, Austin Health, Melbourne, Australia
June 2004
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