2019; Volume 20, No 9, September

IAHPC Book Reviews

By Dr. Roger Woodruff, IAHPC Reviews Editor

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

Palliative Care Book of the Month

This fifth edition is fittingly dedicated to Nessa Coyle, an editor on all four previous editions. She is described as a clinical scholar and a leader in both the clinical and academic fields, which is where I have seen her for as long as I can remember.

The book is divided into seven sections. The first covers general principles and includes chapters on assessment, communication, and advance care planning. The next section has 23 chapters on symptom assessment and management. The third deals with psychosocial and spiritual support. The fourth describes special patient populations and includes chapters on the poor and homeless, as well as patients with mental illness, HIV, and end-stage pulmonary and cardiac disease. The next section discusses end-of-life care across all types of settings, including the ICU and ED. The sixth section comprises 10 chapters that cover all aspects of pediatric palliative care. The last section is about special issues for the nurse in end-of-life care, including chapters on self-care, education, ethical considerations, and dealing with requests for assisted suicide.

Several chapters caught my eye. “The Meaning of Hope in the Dying” provides a good description of what I still find a difficult concept: what hope is, how to assess it, and what may be done to foster and sustain it. The chapter on “Assistance in Dying” provides sensible advice on how one might deal with requests for assisted suicide, but plays down all the documented ill effects that programs of assisted dying have on palliative care nursing and palliative care in general. [Those wishing to know more about these issues are invited read my book, Euthanasia and Physician-Assisted Suicide: Are They Clinically Necessary or Desirable?, available free to read on the IAHPC website.]

If you work in palliative nursing, the Oxford Textbook of Palliative Care Nursing is the recommended reference. The information is comprehensive and well set out. There is adequate use of lists and tables, as well as a clear system of headings that makes specific information easy to find. Each chapter opens with a list of key points and it all seems well referenced.

Purchase includes free personal online access for five years.

Betty Rolling Ferrell is the Director and Professor of Nursing Research at City of Hope Comprehensive Cancer Center in Duarte, California. Judith A. Paice is the Director of the Cancer Pain Program in the Division of Hematology/Oncology at Northwestern University’s Feinberg School of Medicine in Chicago, Illinois. With a single exception, all of the book’s 160 contributors are from North America.

(Roger Woodruff, August 2019)

Other Reviews

This book offers a comprehensive overview of the compatibility of palliative care with the vision of human dignity in the Catholic moral and theological traditions. It presents expert analysis of the major domains of palliative care and how they are compatible with, and enhanced by, the holistic vision of the human person in Catholic health care.

In one book that I reviewed recently, it was emphasized that palliative care was only 50 years old, which struck me as a bit odd. Whilst the most important step in the development of modern palliative care was the opening of St. Christopher’s Hospice in London in 1967 by Dr. Cicely Saunders, it did not acknowledge that the first hospices for the care of the dying were established in France, Ireland, England, and Australia in the late 19^th and early 20^th centuries, principally by various religious orders within the Catholic Church. This book takes that association much further back in time.

The book consists of 14 essays and is divided into three sections. The first is about Catholic theological and moral traditions and teaching on palliative care. There is some interesting material on the history of this association, going back to its Biblical roots. The second is about body, mind, and spirit in palliative care, and how palliative care and Catholic health care share values of service, clinical excellence, compassion, and respect for vulnerable people’s worth and dignity. Admirable, but hardly unique (nor did the book claim that the relationship was unique). The last section is on Catholic social teaching, and institutional and societal issues relating to palliative care.

The topic of euthanasia crops up repeatedly. Whilst I believe that opposition to euthanasia need not have anything to do with religion, it is not surprising that the emphasis in this book has a strong Catholic thread. [My book, Euthanasia and Physician-Assisted Suicide: Are They Clinically Necessary or Desirable?, takes a secular approach to questions about assisted dying.]

This book contains interesting material on the history of palliative care and the considerable alignment between it and Catholic health care.

The editors are described as scholars of Catholic theology and clinical ethics. Dr. Peter Cataldo is Senior Vice-President, Theology and Ethics for Providence St. Joseph Health in Renton, Washington. Dr. Dan O’Brien is Senior Vice-President, Ethics, Discernment and Church Relations for Ascension in St Louis, Missouri — the largest nonprofit health system in the USA and the world’s largest Catholic health system.

(Roger Woodruff, July 2019)

The thesis for this book is that America’s health care system is built on the principle that life should be prolonged or maintained whenever possible, regardless of the costs. But this means that patients may spend their last days suffering from heroic interventions that do little or nothing to prolong their lives. The book’s promotional material notes that, “Increasingly, this approach to end-of-life care is coming under scrutiny, from a moral as well as a financial perspective. Sociologist Livne documents the rise and effectiveness of hospice and palliative care, and growing acceptance of the idea that a life consumed by suffering may not be worth living.”

The first two chapters analyze the professional, institutional, and policy dimensions of “the new economy of dying,” and how the professional outlook of hospice and palliative care is “informed economization.” This felt a bit ambiguous to me, although this may simply reflect my ignorance of terminology in the world of sociology. As a clinician, I believe we should be advocating for what is in the patient’s best interests, and whether that is cheaper or more expensive is a separate and less important consideration. So, if Livne is talking about limiting or curtailing end-of-life care in situations where more intensive therapy would cause unnecessary suffering and/or be futile, I agree. But economization sounds very monetary to me. A study of the archive of a hospital ethics committee shows increasing preoccupation with patients (or families) who demanded more life-prolonging treatment than their doctors thought appropriate. Livne goes on to discuss the interactive processes that palliative care clinicians employed to “tame” patients’ and families’ wishes.

If you work in palliative care and have an interest in the sociological angles, you will enjoy this book and it will give you a lot to think about.

Roi Livne is Assistant Professor of Sociology at the University of Michigan.

Note: Review copy courtesy of Footprint Books. Australian and New Zealand readers can get a 15% discount at the Footprint website using the code BCLUB19.

(Roger Woodruff, August 2019)

The book is primarily written to inform and reassure those who are or soon will be in hospice, and those close to them. The book comprises 21 essays written by people from nine hospice disciplines: doctors, nurses, nurse assistants, social workers, chaplains, music therapists, bereavement counselors, volunteers, and integrative therapists. The editors also note that “professionals in hospice care will find valuable affirmation of their work.”

I found the essays entertaining, as various staff members discuss what drew them to hospice, what they found when they started, and what they learned over the years — including challenging situations, and being rewarded by the gratitude of patients and their families. If you work in hospice and palliative care, it is a refreshing collection of the views of 21 of your colleagues about what hospice means to them and what it is meant to be all about.

However, although the essays are well written and well-meaning, I couldn’t help thinking that only a minority of patients or those close to them would want to read this book or be cognizant of all it says.

Chaim Wender is a Reform rabbi and Patricia Morrison is a social worker and psychologist, both of whom have been associated with the Hospice of Palm Beach county (now Trustbridge) in West Palm Beach, Florida.

Note: Review copy courtesy of Footprint Books.

(Roger Woodruff, July 2019)

In the preface, Preedy notes that, “Optimal terminal and palliative care requires consideration of the patient and family unit as well as cultural and religious sensitivities…and there is an increasing awareness that diet and nutritional support play an integral part in the patient’s holistic well-being.”

The book has 35 chapters, presented in six sections, with contributions from 77 experts from around the world. Section I, “Setting the Scene,” describes palliative care in its bio-psychosocial context, nutrition and quality of life, refractory cancer cachexia, and the nutritional consequences of sedation in palliative care; whilst I am not certain they belong in a book about nutrition, there are two good chapters providing overviews of pain management and communication issues. Section II includes the cultural aspects of enteral feeding, and provides East Indian and Italian perspectives on nutrition in palliative care. Section III covers artificial nutrition and hydration, dysphagia, and anorexia. Section IV covers nutritional assessments, appetite and nausea, vitamin deficiency, and eating-related distress. Section V is about nutritional considerations in non-cancer palliative care patients, including those with HIV; there is a detailed chapter on the use of cannabinoids in palliative nutrition care. The last section includes an impressive list of resources for further information on diet and nutrition in palliative care.

The book is well set out with a liberal use of headings and a list of contents at the beginning of each chapter, making the information accessible. Each chapter ends with a list of key points, followed by a summary in bullet-point form that seems well referenced.

This is a book on nutrition in terminal and palliative care that considers the physical, cultural, and ethical aspects. If you work in palliative care, referring to this volume may help with difficult and complex problems, as well as provide factual information on topics — such as the medicinal use of cannabinoids — as part of palliative nutritional care.

Professor Victor Preedy is a senior staff member of the Diabetes and Nutritional Sciences Research Division of the Faculty of Life Science and Medicine at King’s College, London.

(Roger Woodruff, July 2019)

Roger Woodruff, MD (Australia)
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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