R. S. Downie

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' 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, 3rd 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. Whilst the authors defend the achievements of palliative care and those who work in the profession, they present suggestions for an alternative philosophy. Their philosophy prompts many ethical and philosophical questions about the future of palliative care.

The health promotion movement has gained ever more momentum in the 1990s, at international, national, and local levels. This updated and revised edition of a successful textbook reflects developments in philosophy, policy, planning, and practice since the turn of the decade. It contains new material, such as an account of who is involved in health promotion, more attention to the role of the mass media, and an expansion of the account of the role of the WHO. A new health promotion framework is built up on to the original one and there is a new chapter considering objections to health promotion.

The health promotion movement has gained ever more momentum in the 1990s, at international, national, and local levels. his updated and revised edition of a successful textbook reflects developments in philosophy, policy, planning, and practice since the turn of the decade. It contains new material, such as an account of who is involved in health promotion, more attention to the role of the mass media, and an expansion of the account of the role of the WHO. A new health promotion framework is built up on to the original one and there is a new chapter considering objections to health promotion.

Health care professionals are becoming increasingly aware of the moral dilemmas fundamental to their work. Healthy Respect introduces and analyses the moral concepts and values of health care for all those working in the medical profession, in order that they may examine their own moral and value judgements and appreciate how they might be influenced by them at work. The topics covered include: consent, confidentiality, giving or withholding information, the economics of healthcare, terminal care, resuscitation, testing of drugs Written in a clear, easily accessible style, this book presents many questions, cases and exercises throughout which will stimulate thought and discussion in the reader making it highly suited to all those actively engaged in health care.