Edited by David Clark, Jo Hockley, Sam Ahmedzai
Open University Press
£45 (hardback) £15.99 (paperback)
ISBN 0 335 19606 3 (hardback)
0 335 19605 5 (paperback)
The 300 pages of this book are packed with information on
international developments in palliative care. The editors and
their 32 contributors are a mix of academics and practitioners.
One criticism is that the book is too much like a dry collection
of symposium papers. There are too many diagrams and graphs and
repetitive lists of aims. A certain lack of humanity in some of the
papers makes almost chilling reading. The book would have been both
strengthened and softened by having a section written from the
perspective of the consumer.
However, a reader who digs down into the book will find some
sections that shine with interest and commitment. One chapter
describes palliative care in India and in compassionate words
sketches some of the difficulties faced by patients who travel
hundreds of miles from remote villages to city hospitals where they
cannot be guaranteed a bed and may have to sleep on the floor.
Palliative care in India is not only complicated by poverty and
over-crowding, but also by laws on the use of oral morphine, which
vary from state to state and can mean that a physician may wait
four years before he gets permission to use oral morphine to relive
pain in advanced cancer.
The chapter on east European countries gives an interesting
account of palliative care development since democratic reforms in
the 1980s and 1990s. Helpful contact is now being made with western
hospices for exchanging information, education and materials.
The concluding section puts a strong case for palliative care to
be extended to all chronically sick and dying people, not just
cancer sufferers. This book could be usefully read by politicians
contemplating cutting services, as well as by professionals.
Maureen Oswin is a writer and researcher and author of Am I
Allowed to Cry?