International Association for Hospice & Palliative Care

International Association for Hospice & Palliative Care

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Promoting Hospice & Palliative Care Worldwide


2006; Volume 7, No 1, January



Many ways to help support palliative care.

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Liliana De Lima, MHA

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Roger Woodruff, MD

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Book Reviews

Dr. Woodruff, MD

The Table of Contents for each book reviewed is available in the Bookshop at

Book Reviews

A century of caring in the East End of London

Michelle Winslow, David Clark
Observatory Publications, 2005
Pp 152
ISBN 095441923-5
RRP £10 plus postage
Available from

Here is another wonderful volume of oral history from David Clark’s group, detailing the story of St. Joseph’s Hospice, Hackney during the period 1905 – 2005.  The first chapter is an overview of the hospice’s entire 100-year history and the following chapters explore a particular theme over the hundred years.  There are chapters on the religious and spiritual aspects, on clinical work (including the contribution of Cicely Saunders, who worked at St. Joseph ’s for 7 years), on the place of the hospice within its local community, on the experiences of patients and families, and on the public face of the hospice.  It makes an inspiring tale encompassing love and compassion, much determination, growth and adaptation, and a whole lot more.  I found this book both interesting and enjoyable, and I wonder whether all of us who work in palliative care have not got something to learn from those who devoted themselves to caring for those in the community most in need of help at the end of life. 

Highly recommended.



Mellar Davis, Paul Glare and Janet Hardy (Eds)
Oxford University Press, 2005
337 pp
ISBN 0-19-852943-0
RRP £49.95,  $US98.50
More Info & Purchase

This book is divided into three sections.  The first (2 chapters) deals with opioid receptors and pharmacodynamics as well as opioid pharmacokinetics.  The middle section (12 chapters) deals with the individual opioid drugs.  The last section (7 chapters) deals with opioid choices, opioid rotation, equianalgesia and dosing strategies (including patient-controlled analgesia and spinal opioids), and opioid-resistant pain.  It is a tightly referenced review of the evidence that is available in the medical literature.  There is an absolute mine of information in this book and the editors are to be congratulated for bringing it all together.

The blurb on the back cover says this book ‘presents clear guidelines on the use of opioids when managing cancer pain’, but in many situations there are no randomized controlled trials on which to base those guidelines. I thought the chapters on basic science might have been easier to understand with the more liberal use of cartoon-type diagrams.  Elsewhere, particularly in the chapters dealing with individual drugs, more tables, boxes, or bullet-point lists would have been helpful.

I found the overuse of abbreviations an annoyance.  Using two different abbreviations for continuous subcutaneous infusions, or having two different meanings for the abbreviation PCA, is distracting and should have been edited out.  The book is not inexpensive and would have been better value in a soft cover at half the price.

The editors are to be congratulated for producing the premier reference on opioids in cancer pain. But it is not a book you would whip off the shelf for quick reference and I hope the next edition not only includes new information but is more user-friendly.



Patricia Webb (Ed)
Radcliffe Publishing, 2005
135 pp
ISBN 1-85775-825-0
RRP £19.95, $US38
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This is the second edition of Patricia Webb’s ‘collection of reflections and ideas’ from a variety of professionals with experience and interest in the ethical issues that arise in palliative care. As in the first edition, chapters cover ethical issues in the palliative care environment, honesty, advocacy, informed consent, euthanasia, and the teaching of ethics. There is also a useful new chapter on the theory and practice of critical decision-making. This edition covers a wider range of issues, in keeping with the gradual shift in the clinical domain of palliative care.

The chapter on euthanasia caught my eye, again.  It now contains interesting and useful discussions of the cases of Dianne Pretty and Ms. B.  But it still discusses the practice of euthanasia in the Australian Northern Territory and the State of Oregon , rather than physician-assisted suicide.  And still no mention of the thousands of patients (according to the published reports from the Dutch authorities) who suffer euthanasia without request.  If we are discussing ethics, what about the rights of those patients?

This second edition is a definite improvement on its predecessor and would be a useful auxiliary text for a course in palliative care ethics.  There are more questions than answers, but that is what is required to help individuals and teams to make good clinical decisions.


A Case-based Manual

Roger Worthington (Ed)
Radcliffe Publishing, 2005
129 pp
ISBN 1-85775-846-3
RRP £21.95, $US39.95
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This book is a very practical introduction to the ethical issues that arise in end-of-life care.  It is more focused, practical, and less philosophical than Webb’s ‘Ethical Issues in Palliative Care’.

In the first part of the book there are chapters on ethical theory, the theory and practice of decision-making, decisions at the end-of-life (including euthanasia and physician-assisted suicide), autonomy and rights, and the use of sedation.  The second part of the book comprises six case histories and clinical scenarios.  The descriptions of how the cases were managed are interspersed with reflective commentaries labeled ‘Clinician’s thoughts’.  The case histories are very real and will usefully appeal to anyone who is working in end-of-life care.

This will be a useful text for any course dealing with the ethical issues that arise in end-of-life care. 



Jonathan Parker (Ed)
Quay Books, 2005
167 pp
ISBN 1-85642-266-6
RRP £24.99  $US44.25
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The social worker has always been a central player in the palliative care team and this book describes all aspects of their work in the palliative care setting. Chapters cover the history of social work and the evolution of education for social work, what service users need or expect from palliative care social workers, issues related to culture and ethnicity, working in the multidisciplinary setting, bereavement support, interpersonal skills, dramatherapy and spirituality. The two final chapters deal with social work and palliative care for people with dementia and those who have learning disabilities. 

This will be a useful book for students of social work and for practising social workers coming into contact with palliative care. It will also be useful for other members of the interdisciplinary team and their students in that it will improve their understanding of the social worker’s role.  The material is well presented and set-out, and my only quibble would be that there was no list of the institutional affiliations of the contributing authors.



Julian Hughes (Ed)
Quay Books, 2005
160 pp
ISBN 185 6422658
RRP £29.99

This book is about the provision of holistic, multidisciplinary palliative care for people with dementia.  It takes a truly holistic view, covering physical, psychological, social and spiritual aspects of care.  There are also chapters on ethical decisions, quality of life, and supporting family carers at the end-of-life.  This book is full of practical wisdom and advice and certainly should be available in any institution that looks after people with dementia. It would also be a useful addition to the library shelf on the palliative care ward, to help us with those testing patients whose physical disease is compounded by dementia.

Roger Woodruff,
Director of Palliative Care, Austin Health,
Melbourne, Australia
(January 2006)

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