Reflections and Considerations
Patricia Webb (Ed)
 |
| Hochland and Hochland, 2000
ISBN 1 898507 27 9
138 pp
RRP £14 |
This book is a collection of reflections and ideas about ethical issues. It does not claim to be a textbook on palliative care ethics and the
editor hopes "that you will be challenged, helped, or even outraged". Included are essays on care vs. cure, communication, advocacy, informed consent and euthanasia.
These are important issues for practising clinicians, but some of the discussions here lack any critical appraisal of the material available,
and in some cases tend to be superficial. For example, the first ethical hurdle is identified as being " when to focus care on the patient’s quality of life and cease active therapies".
I would suggest that palliative care focused on the quality of life includes many active therapies of both a medical and psychosocial nature.
The chapter on euthanasia is disappointing. It refers to programs of legalized euthanasia in the Australian Northern Territory and in Oregon,
where there were in fact programs of legalized physician-assisted suicide, not euthanasia. No reference is made to the clinical papers published by the Dutch in The Lancet and the New England
Journal of Medicine that demonstrate that thousands of patients are being euthanased each year without request, never mind consent, and that the numbers are increasing with time.
This book may be of value as an auxiliary text for a guided course in palliative care ethics, and may fulfill its goal of promoting thought and
encouraging research of the literature. But for palliative care clinicians wishing to hone their thinking and skills, it is probably of little value.
Roger Woodruff
Director of Palliative Care, Austin & Repatriation Medical Centre, Melbourne, Australia
(January 2003)
Author Information
Patricia Web is a Principal Lecturer in Palliative Care at St. George’s Hospital, Medical School and Trinity Hospice, London.
Table of Contents
1. Why is the study of ethics important? 3
Webb
2. Care vs. Cure 15
Jeffrey
3. Giving it Straight 43
Draper
4. Advocacy 65
Webb
5. How informed can consent be? 88
Farsides
6. Euthanasia 101
Prouse
7. Teaching ethics in the practice setting 127
Burman
