Oxford Textbook of Palliative Medicine

The new edition of the Oxford Textbook of Palliative Medicine is substantially different from its predecessors. First, there are two new editors of international repute. Second, many new authors have been appointed to rewrite chapters while other sections have been substantially changed. Third, important new topics have been granted additional editorial weight; for example, a completely new section on non-malignant disease includes separate chapters on palliative care in the elderly and in intensive care. There is also a new and most welcome section on the contribution to palliative medicine by allied health professionals: interestingly, this does not include social workers, who have an entire section of their own, although it comprises only one chapter. Given the addition of new material, how have the editors managed to reduce the number of pages from 1283 to 1244? This has partly been achieved by no longer having a separate section on cultural issues. Instead, these have been incorporated into other sections, e.g. bereavement and social work. This concept of embedding cultural issues throughout the text is commendable and reflects the realities of clinical practice in multicultural societies. The only section identified as dealing with ‘cultural aspects’(in its title) focuses almost entirely on spiritual issues, which it does well; it hardly deals with cultural issues at all. The editors have also achieved a smaller volume by using finer (but good quality) paper and a smaller font. Consequently, this edition is one centimetre thinner and one kilogram lighter than its predecessor. Furthermore, there are clearer headings and better use of bold type than formerly. Readers will have to decide whether the smaller font is worth the shelf-space saved. When reading previous editions in bed I felt like the victim in a short story by Edgar Allan Poe; not so with this one. Inevitably in a multi-author volume, there will be some gaps and overlaps. The overlaps matter less because they usually offer different perspectives. Because of my position in undergraduate medical education in Oxford, I looked in vain for a chapter, within the expanded section on ‘Education and Training in Palliative Medicine’(Section 20), to reflect the vast growth and innovation in this area that has occurred across the world since the last edition. Although I did find good material about medical students, this was tucked away in the section on specialist training. This textbook is not a simple ‘how to do it’ guide. The success of previous editions has already made it a seminal resource for anyone wishing to explore the diverse aspects of palliative medicine. But more important than its iconic status is the way the book stimulates thinking, evaluates current practice and encourages new approaches to old problems. Finally, there are up-to-date references, reading lists and, at the end of the last chapter, contact details and website addresses for organizations in 48 countries. This will help the many practitioners who work in isolated settings. Who should buy this? In the 21st century, all libraries should certainly purchase a copy of the new edition, as should palliative care departments, hospices and academic cancer centres. Most palliative care physicians will wish to have their own copy. Those in senior positions, academics and ‘movers and shakers’ in palliative care may also consider this a worthwhile personal investment.