Following publication of the first edition in 1993, the Oxford Textbook of Palliative Medicine rapidly established itself as the definitive textbook on the subject. Each edition has received widespread critical acclaim, and the book is used across the world by the wide range of health care professionals involved in the care of patients with a terminal illness, or chronic, progressive conditions. Existing readers who automatically turn to the textbook will welcome this updated edition of their familiar reference, while it will prove a fascinating read to a new generation of palliative care professionals. The rapid development of the specialty means the textbook is always thoroughly revised between editions, and the fourth edition is no exception. The original editors, Geoffrey Hanks and Nathan Cherny, are joined by four new editors who are leaders in the field and represent a more global editorial approach than ever before. The multi-disciplinary nature of palliative care is emphasized throughout, while an entire section looks at the individual professional roles that contribute to the best-quality palliative care. Ethical issues are explored, including topical chapters on the controversial issues of witholding and withdrawing life-sustaining therapy, and euthanasia and physician-assisted suicide. Communication issues and the psychiatric, spiritual, and psychosocial issues so integral to modern palliative care are covered in depth. As palliative care has become an established and accepted specialty, there is the need for the evidence-base to match other areas of clinical medicine, and a section looks specifically at research in palliative care. The treatment of symptoms is comprehensively covered, with particular focus on the management of pain. Specific chapters are devoted to the role of palliative care in non-malignant diseases and conditions, while education and training are highlighted as critical to future best practice. The Oxford Textbook of Palliative Medicine has continually evolved, keeping pace with the changing face of palliative care, and this new edition ensures that it remains at the forefront of the specialty. No hospital, hospice, palliative care service, or medical library should be without a copy.

Geoffrey Hanks graduated from University College London with a BSc in anatomy and qualified in medicine in 1970. He has been working in palliative medicine since 1979, initially as a research fellow with Robert Twycross in Oxford. For almost 10 years he was consultant physician in charge of the palliative care units at the Royal Marsden Hospitals, London and Sutton, and honorary senior lecturer at the Institute of Cancer Research, University of London, and St Bartholomew's Hospital Department of Clinical Pharmacology. He was appointed to the first Chair of Palliative Medicine in the UK in the United Medical and Dental Schools of Guys and St Thomas' Hospitals, University of London, and was appointed Professor of Palliative Medicine in the University of Bristol in 1993. Positions held include Chairman of the Palliative Care Clinical Studies Development Group of the National Cancer Research Institute in the UK and Chairman of the National NHS Cancer Research & Development Commissioning Group Nathan Cherny is an Australian born, Israeli oncologist and palliative medicine physician. He holds the Norman Levan Chair of Humanistic Medicine at Shaare Zedek Medical Center in Jerusalem Israel. Prof Cherny graduated in medicine at Monash University Medical School in 1983 and then completed a Fellowship of the Royal Australian College of Physicians attaining specialist recognition in both Oncology and Palliative Medicine. He subsequently completed a fellowship in Cancer Pain and Palliative Medicine at Memorial Sloan Kettering Cancer Center. In 1994 Dr Cherny moved to Israel where he helped establish the Oncology and Palliative Medicine Unit at the Shaare Zedek Hospital in Jerusalem. He continues to head that Cancer Pain and Palliative Medicine Service, and, in addition, he continues to practice general oncology. Since 2008 he has been the chairman or the ESMO Palliative Care Working Group. Stein Kaasa is considered to be the leading figure in European palliative care. He is a specialist in medical oncology, radiotherapy, and palliative medicine. Since 1993, he has been the Director of the Palliative Medicine Unit at Trondheim University Hospital, Norway, and Professor of Palliative medicine at the Faculty of Medicine, Norwegian University of Science and Technology (NTNU). He is also chairman of the Unit for Applied Clinical Research and the Institute of Environmental Medicine at NTNU, and Chairman of the Program for Research on Alternative Medicine of the Norwegian Research Council. He was responsible for the development of the core curriculum at the medical school of the NTNU.
He is the current President of the European Association for Palliative Care (EAPC) and serves on the editorial board of several journals including Progress in Palliative Care, Palliative Medicine, and the Journal of Pain and Symptom Management. Russell Portenoy is Chairman of the Department of Pain Medicine and Palliative Care, and the Gerald J. and Dorothy R. Friedman Chair in Pain Medicine and Palliative Care at Beth Israel Medical Center in New York. He is Chief Medical Officer of Beth Israel's Continuum Hospice Care/The Jacob Perlow Hospice, and Professor of Neurology and Anesthesiology at the Albert Einstein College of Medicine. Dr. Portenoy is president of the American Academy of Hospice and Palliative Medicine and a past president of the American Pain Society. He is the recipient of the Wilbert Fordyce Award for Lifetime Excellence in Clinical Investigation and the Distinguished Service Award from the American Pain Society, the Founder's Award from the American Academy of Pain Medicine, and the Bonica Award from the Eastern Pain Association. He serves on the Board of Directors of the American Pain Foundation and chairs various other forums and committees. Nicholas A. Christakis is an internist and social scientist who conducts research on social factors that affect health, health care, and longevity. He is a Professor of Medical Sociology in the Department of Health Care Policy at Harvard Medical School; Professor of Sociology in the Department of Sociology in the Harvard Faculty of Arts and Sciences; and an Attending Physician in the Department of Medicine at the Harvard-affiliated Mt. Auburn Hospital. Dr. Christakis received his BS from Yale University in 1984, his MD from Harvard Medical School and his MPH from the Harvard School of Public Health in 1989, and his PhD from the University of Pennsylvania in 1995. He was elected to the Institute of Medicine of the National Academy of Sciences in 2006. His current research focuses on health and social networks, and specifically how ill health, disability, health behavior, health care, and death in one person can influence the same phenomena in others in a person's social network. Marie Fallon completed her Palliative Medicine Higher Specialist Training at St Thomas' Hospital London and in Bristol and was appointed to the St Columba's Hospice Chair of Palliative Medicine at the University of Edinburgh in 2006. She is based in the Edinburgh Cancer Research Centre and the Western General Hospital, Edinburgh. Her research background is in opioid analgesia, complex cancer pain and barriers to symptom control. She is a founder member of the University of Edinburgh's Translational Research in Pain Group, which has a particular interest in cancer-induced bone pain. She is the Chief Investigator on a portfolio of Cancer Research UK funded multi-centre trials investigating various aspects of cancer pain. She leads a team of several Research Fellows working on various aspects of cancer-induced bone pain.
She is a member of the Advisory Board for Dimbleby Cancer Care and chairs the Pain Sub Committee of the NCRI Palliative Care Clinical Studies Group.

Section 1: Introduction