Peaceful Dying is a work of considerable effort and organization. Dr.
Tobin has painstakingly analyzed his experience as a physician caring
for patients with terminal illness and compiled a step-by-step guide
to help both patients and their families achieve a peaceful
dying. The audience for this work is the communityany
individuals who are attempting to grapple with the issues faced when
either they or a loved one is diagnosed with a terminal condition.
The book begins with an analysis of the dying process and the typical
personal response one has to confronting an end-of-life situation.
From this point, Dr. Tobin describes a 26-step process that he has
structured into the FairCare System for patients to
follow in order to facilitate a peaceful dying for themselves.
The FairCare System emphasizes that patients diagnosed with a
terminal condition must confront their fear of dying and come to
terms with that fear. The only way to do that is to learn as much as
possible about their disease and its treatment from their doctors in
order to assume control over the decision-making that determines the
course of their disease. In effect, Dr. Tobin is emphasizing the
importance of the patient side of the informed consent equation.
Once patients take control of their life, Dr. Tobin
asserts that they are better able to come to terms with death and
examine the questions of ultimate concern in the dying process: What
is my own spiritual destiny? How can I prepare myself and my family
for my death? How can I be sure to be comfortable and not alone?
Dr. Tobin asserts that first one has to begin to address the
existential meaning of life and ones place in the world. The
steps outlined in the FairCare System provide a guide that is
intended to facilitate the patients ability to address these
issues and thereby achieve a peaceful dying.
Dr. Tobin provides a useful framework to facilitate conversations
between patient and family and health care providers. This framework
is a welcome addition to the current literature on end-of-life care.
Although there are medical textbooks to inform professionals
providing care to terminally ill patients, such as the Oxford
Textbook of Palliative Medicine, and journals, such as the Hospice
Journal and the Journal of Palliative Medicine, there are few sources to help the patient and
family confront terminal illness in a practical way. It will be
interesting to see how well the steps outlined succinctly in Peaceful
Dying provide practical assistance for patients with advanced disease
and their loved ones.