A Timely Tome on Ethics in Palliative Care

Abstract

when they clearly offer little symptom benefit and life expectancy is down to months. One example might be the recommendation for urgent endoscopic evaluation of patients with gastrointestinal bleeding who are nearing the end of life. The chapter on diabetic management is a clear and thoughtful presentation of best practices based on goals of care. In contrast, the authors of the chapter on dementia who practice in France are more enthusiastic about the use of cholinesterase inhibitorsd even for mild cognitive impairmentdand atypical antipsychotics than most British or American dementia practitioners. Indeed, many chapters represent expert opinions with minimal acknowledgment of controversies within the field. Chapters typically offer only two or three references, one of which may be a standard Internal Medicine textbook. This work should find a ready audience among practitioners of pain and symptom management whose background is not from family or internal medicine. Alternatively, because of its brief format and readability, it may prove a valuable resource for quick review by medical professionals whose training is more extensive but who wish to reevaluate their practices to incorporate a palliative approach to disease management. Finally, it could be a useful tool for discussion with students or trainees at institutions attempting to combine education in palliative medicine within their standard curriculum.