The ethics of palliation

Ethics in palliative care: a complete guide Macauley, RC New York, NY: Oxford University Press; 2018 (US$63.00; 548 pp) ISBN 9780199313945

When I first received Ethics in palliative care in the mail, I was astonished to learn that the over 500‐page book had only one author. But after sampling chapters that intrigued me, I appreciated engaging with the ideas of a single person.

The book is laid out logically, with five sections, and most of the text deals with key questions in palliative care, such as the right to die and pain and symptom management at the end of life. It begins with an overview of ethics in palliative care, carefully describing the evolution of a sophisticated landscape in which their relationship resides. It provides instruction on how to analyse an ethical issue and how to consider carefully a key question that has clinical pertinence.

The order of the chapters allows the book to be read from cover to cover, but it can also be absorbed a chapter at a time to cater for readers who prefer to dip into the text according to their particular interests. The consistency of structure is vital, and each chapter outlines a case and provides a historical background before moving on to the clinical and ethical context and discussing the ethical arguments in detail.

Macauley lays out clearly his position and views. He puts his biases on display and challenges the reader to form their own opinions. This is perhaps the most engaging aspect of the book, which attempts to provide “philosophical nuance”. It succeeds despite having to maintain broad appeal, and this is why it is a must‐read for anyone involved in palliative care.

The strength of the book is its grounding in clinical practice, drawing on cases and providing real‐world insights into complex clinical management decision making. The book is difficult to criticise, and it is sure to become the standard text in the field. However, I would have appreciated better quality paper and the inclusion of colour figures. Notwithstanding, Ethics in palliative care is a worthwhile investment and a must‐read perhaps for all doctors not just those in palliative care.