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APS Bulletin • Volume 8, Number 6, 1998

Resource Reviews

John D. Loeser, MD, Department Editor

Evaluating Palliative Care: Establishing the Evidence Base

Reviewed by Donna Kalauokalani, MD

M. Robbins, Oxford University Press, New York, 1998, 175 pages, $ 31.50 (softcover), ISBN 0-19-262621-3

This is a thoughtful narrative written by a social anthropologist. It emphasizes the challenges of evaluating the palliative and terminal care needs of adults. The author effectively represents the complexities involved in such endeavors and exposes the difficulties in dissecting the conceptualization and practice of palliative care with the goal of evaluating its intended and unintended consequences.

Packed in this well-designed and produced paperback are chapters structured to give attention to a particular perspective (i.e., patients, family, providers, services, costs). Introductory comments at the beginning of each chapter lay out pertinent questions, subsequent sections review evidence related to this aspect of care, and concluding remarks elucidate gaps in research and offer suggestions for future work.

Though not an exhaustive systematic review, the book captures the main themes in the palliative care literature and illustrates the multifaceted issues involved in the various aspects of end-of-life care. This provides a nice collection of published work in the field. The discussion on underlying policy issues serves as a reminder that there is a great potential for research in this area to have a wide impact.

The author views the process of evaluation as necessarily a creative activity that requires multidisciplinary skills. Awareness of the social and political context in which it is being conducted is also an essential. The issues are remarkably parallel to those encountered in considering the evaluation of chronic pain management.

This book depicts the wide variation in range and types of palliative care that have arisen in different localities and regions and will be useful for health services researchers and clinicians interested in carrying out applied research in the area of care for the suffering.

Donna Kalauokalani is a clinical instructor and senior fellow in the department of anesthesiology and Robert Wood Johnson Clinical Scholars Program at the University of Washington in Seattle.

Reviewer content represents the opinion of the reviewer, not APS.

Please direct your suggestions for future Resource Reviews to John D. Loeser, MD, Department Editor, at jdloeser@u.washington.edu

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