2020; Volume 21, No 2, February

IAHPC Book Review

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

Dr. Roger Woodruff
IAHPC Bookshop Editor
210 Burgundy St, Suite 9
Heidelberg, Victoria 3084
Australia

The book consists of 34 chapters covering just about everything to do with palliative care. The Introduction outlines the nature and history of palliative care, with discussions regarding hope, dignity, resilience, and prognostication. There are chapters on ethical issues, communication, quality of life, spiritual care, the terminal phase, and bereavement. There are eight chapters about pain and physical symptoms; there are separate chapters on psychiatric issues, palliative care emergencies, and complementary and alternative medicine. There are chapters on pediatric palliative care, as well as each of the common nonmalignant conditions that warrant the involvement of palliative care. Lastly, there is a chapter regarding self-care for health professionals.

The book is crammed with information, most of it in bullet-point lists, and there is a generous use of tables. It is reasonably well organized, making the information accessible. Each section is referenced and there appears to be a comprehensive index (of more than 20 pages). I found the font size a bit wearing after a period of time, but that may simply reflect my age. The book is pocket-sized, although your pocket would need to be strong.

The chapter on HIV infection talks about the chronic management of people living with HIV/AIDS, although I suspect palliative care workers have been marginalized unless, of course, the patient is dying. Palliative care for the dying HIV patient is not discussed, which is perhaps a reflection of the relatively small impact of the epidemic in the U.K. (428 deaths in 2018). But this book deserves to be read elsewhere in the world where the Joint United Nations’ Programme on HIV/AIDS (UNAIDS) reports that 770,000 people died of the disease in 2018.

The discussion of euthanasia is too brief and too polite, given that I believe the assisted dying movement is a threat to palliative care as we know it. In Quebec, all public health care institutions, including palliative care units, are required to provide or arrange for euthanasia. McGill University Health Centre complied with the letter of the law when it arranged to transfer patients from its palliative care unit to be lethally injected elsewhere in the institution. But the Quebec Minister of Health ordered that euthanasia be provided in the unit, citing “patients’ lawful right to receive end-of-life care.” Quebec law allows hospices to opt out of providing euthanasia, but when some did so, the Minister of Health denounced them for “administrative fundamentalism,” declaring their refusal “incomprehensible.” There are calls for the withdrawal of public subsidies for these hospices. In Victoria, there have been 140 requests for assisted dying in the first six months of the program, compared to the fewer than 12 predicted; makes me wonder how much good palliative care any of them received, and how often assisted dying was “suggested” by their “caring” doctor. Whilst the book discusses the well-documented observation that only a tiny fraction of individuals who support the legalization of assisted dying will choose it for themselves, it is not emphasized enough. So all we hear is the constant barrage from the proponents, complete with a lot of identity politics and virtue signalling. [My review of matters related to assisted dying is available free on the IAHPC website.]

The book has an international flavour. Of the 46 contributors, most are from the U.K. and Australia, with smaller numbers from elsewhere in Europe, Asia, Africa, and the Americas.

It is a good, affordable, pocket-sized reference providing reasonable coverage of palliative care.

(Roger Woodruff, December 2019)

• Dr. Woodruff is a Lifetime Member of the IAHPC Board and Past Chair. His bio may be found here.

NB: Review copies become the property of IAHPC and are not returned to the author. Only books related to palliative care that have been approved and have an ISBN will be reviewed. Due to the large number of requests, we cannot provide exact dates of when books will be reviewed.

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