Whole Person Care—Is It Coming of Age?

Whole Person Care—Is It Coming of Age?

808 Book Reviews Nonphysician clinicians such as nurses, physical therapists, and pharmacists also can benefit from this book. Researchers intereste...

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808

Book Reviews

Nonphysician clinicians such as nurses, physical therapists, and pharmacists also can benefit from this book. Researchers interested in chronic pain will find this book valuable both as a guide to the field and as a resource for measurement tools. In summary, Chronic Pain: An Integrated Biobehavioral Approach is a unique offering that meets several pressing needs in the field. It provides a comprehensive, integrated narrative on chronic pain, including its assessment and therapy. It also provides a solid articulation of the biobehavioral approach to chronic pain, making this accessible to clinicians working within the conventional medical model. The materials on assessment tools and treatment protocols are an excellent resource that can save interested clinicians and researchers dozens of hours of literature searching. The quality of the writing is high, and the book succeeds in holding the reader’s attention. This affordable book is a solid investment for everyone working in the chronic pain area. doi:10.1016/j.jpainsymman.2012.01.003

Whole Person CaredIs It Coming of Age? Neil A. Hagen, MD, FRCPC

Whole Person Care: A New Paradigm for the 21st Century Edited by Tom A. Hutchinson Published by Springer, New York, NY, USA 2011, 258 pages, $39.95 (Hardcover)

Neil Hagen, MD, FRCPC, is Professor and Head, Division of Palliative Medicine, University of Calgary; and Executive Director, Provincial Tumor Programs, Alberta Health Services Cancer Care, Calgary, Alberta, Canada.

Vol. 43 No. 4 April 2012

Whole Person Care: A New Paradigm for the 21st Century has set for itself a daunting task. It intends to characterize, and even catalyze, a paradigm shift in health care planning and delivery. It describes a change in perspective, away from a largely traditional model of disease diagnosis and disease cure, to a more balanced approach, where both the disease and the person with the disease are front and center. This book is authored by great luminaries in the field who are internationally respected for their depth of understanding of the nature of suffering, the origins of healing, and quality of life. Each chapter can be read on its own, yet there is cohesion and a similar writing style between them. In brief, the book tells a story, one chapter at a time, about a program of care housed within McGill University’s Faculty of Medicine. Chapters address distinct though often overlapping aspects of the program and the principles that underpin the program. The central thesis is that the primary goal of medicine is healing. The term ‘‘healing’’ has in fact not been well characterized over the centuries within our health care community. The book posits that modern healing, as understood by medicine, is characterized by a dichotomy. On the one hand is the Hippocratic modeldwith diseases, the hope for cure, the goal of survival, and a scientific basis of knowing. On the other hand is a patient-centered perspective, the Asklepian modeldwith suffering, the hope for healing, the goal of growth, and ways to know beyond the scientific method, including spirituality, meaning-making, and connections. The proposal is that all of us health care providers would be better at our craft and trade if both models were to become integrated and interdependent within our Western health care system. There are two chapters that are so well crafted and inspiring, they would by themselves make the book highly recommended. The first is a brilliant chapter by New York ethicist Eric Cassell on ‘‘Suffering, Whole Person Care, and the Goals of Medicine.’’ He provides deep insight into the nature of suffering, patient self-awareness, and approaches the clinician can use to promote healing. The second is a gem of a chapter on self-care and self-awareness of the

Vol. 43 No. 4 April 2012

Book Reviews

clinician, a superb read that is full of tips of great value to mitigate against burnout and compassion fatigue. Other remarkable chapters are on the congruent physician-patient relationship; the nature of empathy, sympathy, compassion, and the goals of medicine; mindful clinicians and mindful patients; death anxiety; and professionalism. A chapter dedicated to the instruction of whole person care in medical school makes a compelling case that ‘‘physicianship’’ can be taught, and taught well, within an otherwise conventional undergraduate medical school curriculum. Woven through the book is the broad overarching concept of spirituality and the appropriateness of physicians and other clinicians to be mindful of spiritual considerations in their delivery of health care. ‘‘Whole person care’’ is still a young area of study, and the growth pains remain significant. At times, the book stumbles over words, using jargon or acronyms that are generally best avoided in new fields of study. At other times, the book falls prey to a kind of zealotry against the traditional medical model, for example, ‘‘.Doctors in this stance are both embarrassing and dangerous’’ (p. 39). Further, the book accuses the empirical model of knowledge generation as being narrow and insufficient. In other places, the book boldly but inaccurately presents an empirical evidence base to support the use of complementary therapies but mistakes deductive reasoning and laboratory-based observation as if they represented prodigious direct evidence of clinical benefit. This book is highly relevant to the readership of the JPSM. It is timely and, with the exception of the issues noted above, is authoritative and inspiring. Is ‘‘whole person care’’ coming of age? Probably it isdbut I would recommend you have a look at the book and decide for yourself. It’s a really good read. doi:10.1016/j.jpainsymman.2012.02.001

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Exploring Health Care Ethics Through Film Ben A. Rich, JD, PhD

The Picture of HealthdMedical Ethics and the Movies Edited by Henri Colt, Silvia Quadrelli, and Lester Friedman Published by Oxford University Press New York, NY, USA 2011, 527 pages, $39.96 (Paperback) In the interests of full disclosure, I should begin this review by noting that, as an academic bioethicist, I know personally a number of the contributors to this volume. Nevertheless, to the fullest extent possible, I will seek to objectively and dispassionately evaluate its important contribution to the literature. The old saying ‘‘a picture is worth a thousand words’’ might be tailored to this collection of essays by suggesting that a well-chosen video clip can be worth a raft of PowerPoint slides. It is in this spirit that, in the first essay, one of the founding fathers of contemporary American bioethics, Al Jonsen, reflects on his early years as the resident ethics faculty member of the University of California, San Francisco School of Medicine. Fresh from his experience of teaching philosophy to college students, Jonsen quickly realized that ‘‘the airy abstractions of philosophical ethics floated far over the heads of medical students concerned with bodies and diseases, not theories and conjectures. I had to find a new mode of communication.’’ The mode to which he turned was the classic 1931 film Frankenstein. Jonsen observes that ‘‘[i]nformed consent, the determination of death, life support, the ethics of research, transplantation e usual topics of those

Ben A. Rich, JD, PhD, is an attorney and Professor and Alumni Association Endowed Chair of Bioethics at the University of California, Davis, Sacramento, California, USA.