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 the authors present their argument that the palliative care approach has become too busy and over professionalised and that it therefore has significant weaknesses. The authors have bravely and most successfully to my mind achieved their objective of producing a critique and reconstruction for the philosophy of palliative care. The philosophy of palliative care critique and reconstruction paul keeley consultant in palliative medicine is not so much a philosophy of palliative care as a theological tract it is to be highly recommended to professionals in palliative care it makes urgent arguments that should stimulate debate within the specialty. The philosophy of palliative care critique and reconstruction fiona randall and r s downie encourages the reader to understand fully the basis of the criticism allowing them to consider whether changes to the philosophy are warranted or to stimulate counter arguments in defence of the philosophy. It was baroness julia neuberger who described the nhs as a theological institution in the pages of this journal bmj 1999319 1588 9 randall and downies new book in which they argue that end of life care has become overprofessionalised is not so much a philosophy of palliative care as a
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