IAHPC's Book of the Month
PRINCIPLES AND PRACTICE OF PALLIATIVE CARE AND SUPPORTIVE ONCOLOGY, 3e
Ann M. Berger, John L. Shuster and Jamie H. Von Roenn (Eds)
Lippincott Williams and Wilkins, 2006
944 pp ISBN 0-7817-9595-8
RRP $US199.00, £107.00, $AU328.90
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As one who practises in both medical oncology and palliative medicine, I have often said that palliative care is not just about terminal care and that the principles of palliative care, both psychosocial and medical, should be incorporated in the care of cancer patients much earlier in the course of their journey. And that’s what this book is all about.
The book is divided into six sections. The first deals with symptom control and includes the management of pain, constitutional symptoms and a system-by-system coverage of other symptoms. Section II covers the medical and the complete psychosocial spectrum of care in palliative care, including spirituality, bereavement care, and staff stress and burnout. The third section deals with ethical considerations—advance directives, withholding and withdrawing treatments, and physician-assisted death. Section IV deals with special interventions—haematological support, nutritional support, rehabilitation, and complementary and alternative approaches to treatment. Section V covers special populations—paediatrics, geriatrics, patients with HIV/AIDS and palliative care in the ICU. The final section deals with research issues.
Arguably the hardest chapter in the book to write would have been the one on physician-assisted death. The result seems to have an appropriate balance. But there is no mention of the Dutch experience. It’s not just my hobby-horse of the thousand patients a year that are euthanized without request, never mind consent, but it is an example that the best-laid safeguards against abuse do not work. The experience in Oregon is discussed in more detail, but no comment is made as to why so few patients with cancer use the program. During the period 1998-2004, there were about 43,000 deaths from cancer in Oregon. Now if more than 60% of Oregonians favour physician-assisted suicide (PAS), that could have lead to as many as 26,000 requests. But during that period there were only 164 deaths by PAS of patients with cancer, which is one-third of one percent.
I can nit-pick, but I have to admit that I did not come across anything to which I took exception. There is a reasonably generous use of illustrations and tables, but in a book conveying so much information, I would have liked more tables and diagrams and algorithms. Overall, it’s an excellent publication and the editors are to be congratulated: it provides a comprehensive coverage of the field, it’s up to date, it’s well-referenced and well-indexed. It belongs on the shelf in the hospice/palliative care ward and the medical oncology ward.
Principles and Practice of Palliative Care and Supportive Oncology
Visit our Hospice and Palliative Care Bookshop at:
www.hospicecare.com/bookshop/
Roger Woodruff
Director of Palliative Care, Austin Health,
Melbourne, Australia
(February 2007)
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