IAHPC book reviews

2014; Volume 15, No 9, September

IAHPC book reviews

By Dr. Roger Woodruff

Palliative Care book of the month

The inner life of the dying person
Allan Kellehear
Columbia University Press, 2014
264 pp
ISBN 978-0-231-16785-7
RRP $US 35.00, £ 24.00

Review copy supplied by Footprint Books FootPrint.

How does it feel to die? If you asked that question to a roomful of palliative care workers, you would probably get no two answers quite the same. Kellehear believes we are hung up on an increasingly fragmented view of dying as a medical and psychological set of problems, and proposes a more holistic and interdisciplinary portrait of the inner life of the dying person.

In constructing this picture, Kellehear starts by focusing on what dying people—those consciously aware and expectant that death will come soon—say and do. He does not discuss those people with advanced disease who will not acknowledge, to themselves or anyone else, any notions of death or dying. He also makes the point that the perspective of the dying person is not that of the onlooker, be they caregivers (family or professional), survivors, rescuers or academics. Chapters explore several of the emotional and spiritual dimensions of dying—suffering, loss, anger, sadness, fear—challenging assumptions, exploring the possible meanings, and showing how some of these apparently negative things may have a positive side resulting in increased love and appreciation, hope and even happiness. I liked Kellehear’s way of making these reactions and responses sound normal and not part of a medical / psychological puzzle; after all, dying is the final part of normal life.

I can recommend this book to anyone who works in palliative care. It is well written and the discussion is well presented. I found it both interesting and refreshing. You may not agree with everything he says but, in one way or another, it will influence how you regard the dying patients you care for and, well, you know, it’s something coming to us all.

Other reviews

Palliative care nursing 4e
Quality Care to the End of Life
Marianne Matzo and Deborah Witt Sherman (Eds)
Springer Publishing Company, 2015
682 pp
ISBN 978-0-8261-9635-4
RRP $US 95.00, £ 81.95

Review copy supplied by Footprint Books FootPrint.

This is the 4th edition of this work, which has been updated and significantly expanded. The presentation is similar, with a list of Key Points at the start of each chapter, and a critique of a selected “Evidence-based practice” article from the literature at the end. Case studies are interspersed and the text seems adequately referenced.

The book is divided into four sections:

The first is about palliative care in general with chapters on inter-professional care and legal and ethical aspects. The section on physician-assisted dying deals mainly with the state of Oregon and avoids the minefields of Holland, Belgium and Switzerland. I was interested to see that the ANA has not supported assisted dying because of the profession’s central moral axiom - respect for persons - and nursing’s historical commitment to “to promote, preserve and protect human life.” More the pity that some medical associations do not have the same resolve.

The second is about holistic care with chapters on culture and spirituality, communication, caring for families, sexuality, rehabilitation as well as grief and bereavement.

The third provides an overview of the diseases encountered in palliative care including cancer and end-stage cardiac, pulmonary, neurological, hepatic and renal disease and HIV/AIDS. In the cardiology chapter, there is a good discussion about the procedure and ethics involved with deactivating implanted cardiac defibrillators (ICDs) in the terminally ill. But, as with all the other sources I have reviewed, there is no specific advice about what the nurse should do at 3 a.m. if the patient is about to die, or has died, but are continuing to receive repeated electric shocks; a few of the available guidelines have unhelpful comments such as using a magnet that can be obtained from the manufacturer.

The fourth deals with symptom control, including chapters on pain, dyspnea, psychological distress, GI symptoms, and fatigue. There is a new chapter on the management of post-traumatic stress disorder (PTSD) in palliative care, which is interesting, although I have never encountered it as a major issue in the management of patients with advanced disease.

As with the previous editions, this book provides a broad and comprehensive introduction to palliative care nursing and should be considered as a core text wherever that is being taught.

Roger Woodruff, MD (Australia)
August 2014
Dr. Woodruff is a Lifetime Member of the IAHPC Board and Past Chair. His bio may be found here.

Note for authors and publishers: If you wish to have your book reviewed, please send to:

Dr Roger Woodruff
IAHPC Bookshop Editor
210 Burgundy St, Suite 9
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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