2010; Volume 11, No 11, November

Roger Woodruff, MD


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Palliative Care Book of the Month and other Book Reviews

Palliative Care Book of the Month

Integrating spirituality into health care

Christine M. Puchalski and Betty Ferrell

Templeton Press, 2010
266 pp
ISBN 978-1-59947-350-5
RRP $US34.95  £23.99

The ink had barely dried on my statement that ‘spiritual care is part of the palliative care package’ when this book landed on my desk.  It is based on a consensus conference and associated activities, the purpose of which was to establish a common language and model for interdisciplinary spiritual care, identify resources and tools that have practical applications, and develop recommendations that will advance the practice of spiritual care in palliative care settings.  Although this volume focuses on palliative care, it should be noted that much of what is said is applicable in non-palliative care settings.

The first part of the book provides an overview of spiritual care including a discussion of the concept, the historical context, and why spiritual care is so important.  The second part provides recommendations for implementing spiritual care and includes chapters on spiritual care models, spiritual care history taking, the spiritual care plan, as well as interdisciplinary issues, training and quality improvement.

Much effort has gone into the inclusion of the non-religious aspects of spirituality and spiritual care.  This makes statements like ‘…whether a person is experiencing a serious spiritual crisis and therefore needs an immediate referral to a board-certified chaplain..’ stand out; to me, that implies spiritual crises are all to do with religion. With that off my chest, I have to say this book was a pleasure to read—the flow of information is well-ordered and the delivery smooth. I praised Puchalski’s previous publication (A Time for Listening and Caring, OUP 2006); well, with some help from Betty Ferrell, she has done it again.

Because spiritual care means so many different things to different people, this book is an important step in unifying our ideas and standardising (and, hopefully, improving) our practices.  I certainly think it has a place on the bookshelf in any hospice or palliative care service, where it will allow experienced personnel to assess their service’s spiritual care program and will provide the novice with a succinct overview of what spiritual care is all about.

Roger Woodruff (Australia), an IAHPC Board Member
(October 2010)

Other Reviews


Holland, Breitbart, Jacobsen, Lederberg, Loscalzo and McCorkle (Eds)

Oxford University Press, 2010
ISBN 978-0-19-536743-0
RRP $US149.95, £96.00

My copies of Jimmie Holland’s Handbook of Psycho-Oncology (1989) and the first edition of Psycho-Oncology (1998) are well used and I very much looked forward to looking at this second edition.  As with the previous edition, it contains just about all there is to say about psychology and oncology and underlines the advances that have been made in the field over the last 10-20 years.  With 97 chapters and 165 contributors, it is encyclopaedic in coverage

The book is divided into a number of sections including Behavioural and Psychological Factors in Cancer Risk, Cancer Screening, Screening for Genetic Susceptibility, Psychological Issues related to Site of Cancer, Management of Specific Symptoms, Palliative and Terminal Care, Psychiatric Disorders, Interventions, Special Populations, Family Issues, Survivorship, Building Psychosocial Programs, and Ethical Issues.  The second edition has fewer pages than the first, but I suspect the content may be greater.  The material is well set out and accessible and generously referenced.

The chapters in the palliative care section are good, including Liliana de Lima’s contribution on the International Aspects of Palliative Care.  However, there is much that is very pertinent to palliative care in the sections on psychological disorders, interventions for them, and the care of the family.

Psycho-oncology has become an important and integral part of managing patients with cancer and their families and this book should be available for reference in the library of any cancer treatment centre. Palliative care professionals will also benefit from access to this book, which is a quite comprehensive treatise.


Balancing honesty with empathy and hope

Anthony Back, Robert Arnold and James Tulsky

Cambridge University Press, 2010
158 pp
ISBN 978-0-521-70618-6
RRP $US40.50, £24.99

I issued a challenge a few months back for a concise, clear and practical book about communication in oncology and palliative care.  Well, here it is.  Written by practising physicians, it gives you the do’s and don’ts and the reasons for them. It also points out the pitfalls, how to avoid them, and how to dig yourself out of trouble if you’ve fallen in.  The book has separate chapters on breaking bad news, making treatment decisions, discussing prognosis, how to conduct a family conference, dealing with conflict, and transitions to end-of-life care.  Each chapter has a road map to guide the discussion and includes analyses of consultation conversations that did or did not go according to plan.  I would recommend this book to all trainees in oncology and palliative care.  They can read it in a single night, but my guess is that they will be coming back to it repeatedly after conversations in the clinics proved more difficult than expected.


Transforming the Care of Serious Illness

Diane E. Meier, Stephen L. Isaacs, Robert G. Hughes (Eds)

Jossey-Bass (Wiley), 2010
452 pp
ISBN 978-0-470-52717-7
RRP $US75.00 £42.50

This volume, published by the Robert Wood Johnson Foundation, aims to inform the debate about health care reform and the provision of palliative care in the United States.  But it is much more than that.  The opening chapter is a review of the development, status, and future of palliative care written by Diane Meier, the director of the Center to Advance Palliative Care.  There follow 25 very carefully selected reprints of seminal articles and reports that provide a rich tapestry of the history and goals of palliative care.  The list of authors reads like a who’s who of palliative care, including Elisabeth Kubler-Ross, Daniel Callahan, Balfour Mount, Kathleen Foley, Cassell (Eric and Christine) and Emmanuel (Ezekiel and Linda), to name but a few.  Selecting the 25 papers from the hundreds or thousands on offer must have been a very difficult task.  One name that came to mind that might have been included was Christina Puchalski (A Time for Listening and Caring, OUP 2006), for I believe any discussion should emphasize the fact that spiritual care is part of the palliative care package.   


A Guide for Effective Dosing

Mary Lynn McPherson

American Society of Health-System Pharmacists, 2010
196 pp
ISBN 978-1-58528-198-5
RRP $US 35.00  £26.50

I once wrote that pain and symptom control must come first, as it is not possible to have a meaningful conversation about psychosocial or spiritual issues with a patient with unrelieved pain.  This book is about optimising pain control with opioid drugs for those with moderate or severe pain.  In a very clear and practical way, it describes the use of opioids, changing to different routes of administration, changes to different opioids, the treatment of breakthrough pain, the difficulties that can be experienced with methadone, and the challenges of transdermal fentanyl and neuraxial opioids.  It is written in an almost conversational manner, sometimes humorous, with lots of case anecdotes and highlighted clinical Pearls and clinical Pitfalls.  Having been through the exercise, I think that these are important, for to present all this information in a dry, prescriptive manner is enough to narcotize the keenest reader.  For someone with some experience with opioid therapy, I am not sure this book is concise enough for day-to-day use in the ward, but it would certainly be very useful for postgraduate courses in medical and nursing palliative care, where the finer detail of opioid therapy is sometimes overshadowed by matters related to psychosocial and spiritual concerns.  I have to say that it warmed my heart to read about the author ‘spending a fair amount of time banging my head on the desk wrestling with the limited, yet frequently conflicting, information published on opioid conversion calculations’.  The scientific basis of what we do in the clinic is incomplete, but I think this book provides sound and common sense advice where the science is lacking.


How it feels to be young and dying

Amber Turk, edited by Margaret Brown

Wakefield Press, 2010
99 pp
ISBN 978-1-86254-886-2
RRP $AU22.95

Available at www.wakefieldpress.com.au or www.fishpond.com.au

Amber Turk was diagnosed with an inoperable brain stem glioma when she was 27 years old.  This is her journal of the twelve months that followed, until the time of her death.  Here is a very honest record of what one 27-year-old dying of cancer thought and felt, rather than what we think they could or should be thinking and feeling.  One cannot help but be struck when she expresses gratitude for what she thinks was a wonderful life, despite the raft of negative events that would have overwhelmed many people.  The other message is that she benefited most from people who had the time and will to listen, hence the title.

This book should definitely be on the reading list for any course in palliative care.  And for those of us already working in palliative care, the frankness makes it a pleasure to read, and the honesty provides food for thought about how we can provide the best support for patients like Amber.


An integrated approach

Jenny Buckley

Wiley-Blackwell, 2010
331 pp
ISBN 978-0-470-05885-5
RRP  $US64.99, £19.49

This book is about an approach to palliative care rather than being just another primer about palliative care.  (The book has no preface, so I cannot be sure of Buckley’s aims and intentions).  It is written for any health care professional who might be involved in the care of patients requiring palliative care and their families.

The book opens with a chapter on the evolution of modern palliative care.  Sadly, Josefina Magno, whose original organization (IHI) gave birth to both the American Academy (AAHPM) and to IAHPC, isn’t mentioned in the list of international leaders in the field; and the section on international perspective doesn’t mention IAHPC.

That said, there are useful chapters on psychosocial care, communication, hope and spirituality, living with dying, advance care planning, and grief and bereavement.  Each chapter opens with a list of key points and ends with a short list of suggested reading. 

The chapters on pain and physical symptoms were a disappointment.  They provide general material about the approach to care but, for me, they lacked the detail one would want in making every day treatment decisions.  Sometimes I felt there was more discussion about complementary therapies than about down to earth palliative medicine and nursing.

Roger Woodruff (Australia), an IAHPC Board Member
(October 2010)

Dr. Woodruff is a Lifetime member of the IAHPC Board and his biography may be viewed at:

View over 100+ IAHPC hospice & palliative care book reviews

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Heidelberg, Victoria 3084

Note: Review copies become property of IAHPC and are not returned to the author. Only palliative care related books which are previously approved will be reviewed. Due to the large number of requests, we can't provide exact dates of when books will be reviewed.

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