Palliative care is a rapidly growing area within health care and one i n which there are many ethical dilemmas. Chronically and terminally il l patients increasingly wish to take control of their own lives and de aths, resources are scarce and technology has created controversial li fe-prolonging treatment. This book has been written by a clinician and a teacher and writer of health care ethics to provide all those who c are for the terminally ill - doctors, nurses, social workers, physioth erapists, clergy and other carers - with the concepts and principles t o assist them in difficult...

Medical decisions are usually thought to follow from evidence-based sc ience, but this is an oversimplified view. The book investigates the c omplex nature of evidence in medicine, makes a case for the centrality of clinical judgement, and indentifies the elements of good judgement in decisions made in the clinic, in public health, and in resource ma nagement.

Palliative care is undergoing a period of rapid change, both in perceptible ways such as legislation, policy, and clinical guidelines, but also in its philosophy and ethics. There is ambiguity surrounding even the definitions used, ranging from palliative care, to supportive care, to end of life care. Randall and Downie propose that the uncertainties in the current thinking on end of life care may change the two ethical (and legal) principles on which modern medical care has been built--that practitioners must obtain the informed consent of the patient for treatment, and that practitioners...