An Essential Textbook on Pediatric Palliative Care
Oxford Textbook of Palliative Care for Children, 3rd Edition
Richard Hain, Ann Goldman, Adam Rapoport, Michelle Meiring (editors)
Hardcover, 2021
Also available: eBook, Oxford Medicine Online
ISBN: 978-019882-1311
MSRP: $175 USD
Reviewed by Naomi Goloff, MD FRCPC FAAHPM
The third edition of the Oxford Textbook of Palliative Care for Children continues to build on excellent content from the first and second editions. It is a comprehensive text and thoroughly updated, but at 536 pages it is slimmer than the previous editions. It continues to reflect the changes ongoing in the specialty of palliative care for children and highlight its intricacies. Chapters are written by international interprofessional experts in palliative care for children representing 14 countries around the world. The layout is easy to follow, with chapters including relevant cases and boxes to highlight key takeaway points. It is divided into four main sections by overall theme and includes a master formulary for common medications in palliative care.
Section I, Foundations of Care (Chapters 1-5), includes the history and epidemiology of palliative care for children, and background chapters on communication, ethics, decision-making, and spirituality.
Section II, Child and Family Care (Chapters 6-13), includes comprehensive chapters on assessment, psychosocial impact on the child and the family, childhood views on death and bereavement, as well as specific chapters devoted to school and adolescents and young adults.
Section III, Symptom Care (Chapters 14-28) is the largest section, with multiple chapters focussed on pain care, including multimodal analgesia, opioids, challenging pain, and a section on an integrative approach to pain and symptoms. Non-pain symptoms (such as gastrointestinal symptoms, neurological symptoms, depression) are then addressed in detail in separate chapters. The final chapter of the section focusses broadly on palliative care for children with communicable illnesses rather than HIV/AIDS, as in the previous edition of this textbook.
Section IV, Delivery of Care (Chapters 29-38), includes chapters on care the in ICU, end-of-life care, and delivery of care globally. This edition has retained the important chapter on health care providers’ responses to the death of a child. There are several new chapters covering: perinatal palliative care, care planning, and teamwork. The final chapters of the section focus on education, quality improvement, and research.
Although a full review of the strengths is beyond the scope of this review, I want to highlight a few. The addition of a comprehensive chapter focussed on perinatal palliative care gives a good introduction to this evolving subspecialty and is a necessity for any modern children’s palliative care textbook. Not only is this textbook comprehensive in scope for the care of different age populations, but it is also comprehensive in scope along the disease trajectory. Chapter 31, “Planning care,” lays out advance care planning for children with serious illness throughout the disease trajectory in a way that will resonate with any pediatric clinician. It should be required reading for all those who care for children with serious illness and their families.
Lastly, and what I consider to be one of the most praiseworthy aspects of this edition, is that certain chapters (e.g., Chapter 12, “Impact on the Family”) involve the collaboration of bereaved parents. Including the family voice is critical to ensuring that what we learn and teach is informed by, and reflects, the lived experience of these children and their families.
In conclusion, this is an essential textbook for anyone who works with children with serious illness or their families, or who teaches or supports learners working with this population now or in future.
Richard Hain is clinical lead, Welsh Paediatric Palliative Medicine Managed Clinical Network; visiting professor, University of Glamorgan; and honorary senior lecturer, Bangor University, Wales, UK
Ann Goldman is a pediatrician and palliative care specialist, in London, UK.
Adam Rapoport is medical director of the Paediatric Advanced Care Team, The Hospital for Sick Children, University of Toronto, as well as Emily’s House Children’s Hospice, Toronto, Ontario, Canada.
Michelle Meiring is with Paedspal and the Department of Paediatrics and Child Health, University of Cape Town, South Africa.
Dr. Naomi Goloff is a pediatric palliative care specialist and education director of the Pediatric Advanced Care Team at Montreal Children’s Hospital, McGill University, and Le Phare Enfants et Familles in Montreal, Quebec, Canada.
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