The Philosophy of Palliative Care: Critique and Reconstruction

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Overview

The idea of a philosophy of palliative care emerged with Cicely Saunders' vision for 'a good death', and was developed further with the WHO definition of palliative care. It is now being applied not only to cancer patients, but to all patients in end of life situations. As this 'palliative care approach' model advances, it is important to pause and comment on its effectiveness. It is a philosophy of patient care, and is therefore open to critique and evaluation.

Using the Oxford Textbook of Palliative Medicine Third Edition as their basic reference, Randall and Downie present their argument that the palliative care approach has become too busy and over-professionalised, and that it therefore has significant weaknesses. They examine the framework of the specialty - quality of life, autonomy, dignity, patient-centredness, and the priority assigned to relatives in the remit of care - and the moral problems associated with implementing such a philosophy. The resource implications of various health care policies are also discussed in relation to the WHO definition.

The contradictions of palliative care literature come under scrutiny as the gulf between the rhetoric and the clinical application of its theory is discussed. Whilst the authors defend the achievements of palliative care and those who work in the profession, they present suggestions for an alternative philosophy. In order for palliative care to evolve, it must return to its original simplicity The reconstruction proposed in this text is fascinating reading and prompts many ethical and philosophical questions about the future of palliative care.

About the Author:
Fiona Randall has served on the BMA andAssociation for Palliative Medicine ethics committees

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Editorial Reviews

From the Publisher
"The authors have bravely, and most successfully, to my mind, achieved their objective of producing a critique and reconstruction for the Philosophy of Palliative Care. Within a slim and readable 226 pages, they expose a significant number of basic inconsistencies and contradictions that they find in the currently accepted 'norms' of the specialty. But rather than leave it at that somewhat negative position, they also defend the achievements of the specialty and proceed to record the positive parts of the current situation...All in all, an excellent and easily accessible text which I suspect will be referred to a great deal in debates and discussions about the future of Palliative Care."—Oncology News
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Product Details

  • ISBN-13: 9780198567363
  • Publisher: Oxford University Press, USA
  • Publication date: 5/31/2006
  • Pages: 252
  • Product dimensions: 9.10 (w) x 6.10 (h) x 0.50 (d)

Meet the Author

Fiona Randall is a consultant in palliative medicine, with a background in health care ethics and philosophy. She has served on BMA ethics committees, the Association of Palliative Medicine ethics working party, and has been recently involved in drafting the UK law on decision making for patients lacking capacity. She is also on the editorial board of the Journal of Palliative Care. Robin Downie has been a member of various government and professional committees and working parties dealing with issues of medical ethics. He is now an Honorary Professorial Research Fellow and Emeritus Professor of Moral Philosophy at the University of Glasgow.

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Table of Contents

Framework and concepts
1. Root, traditions and philosophy
2. Quality of life
3. Autonomy, dignity, respect and the patient centred approach
4. Relatives
Interventions, effectiveness and cost
5. Control of symptoms and prolongation of life
6. Resuscitation and advance statements
7. Assessment and treatment of psychosocial and spiritual problems
8. Resource allocation
Critique and reconstruction: some suggestions for a better way
9. Critique and reconstruction: some suggestions for a better way

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