STATE OF THE ART Cicely Saunders, RIP Remembering the Founder of the Hospice Movement hen Dame Cicely Saunders A committed Christian who had expe- died this past summer at the rienced a dramatic conversion, she Wage of 87, few Americans included spiritual well-being among noted her passing. But her influence the things that should be encouraged on medicine and caregiving has been and nurtured in the dying. In her book, enormous. Credited with being the Living With Dying, published in 1983, founder of the modern hospice move- she wrote about the need for end-of- ment, Saunders forever altered the way life caregivers to consider the “men- the medical profession treats the termi- tal, social, and spiritual pain” of their nally ill. In the process, she helped fos- patients as well as their physical pain. ter respect for life and for the dignity of In an early article outlining her ideas those suffering from illness. for end-of-life care, Saunders indicted Dame Cicely’s vision began with a medical professionals for failing to chance encounter, in 1948, with David grasp just how important they were to Tasma, a Polish man who had escaped patients who were suffering from ter- from the Warsaw Ghetto and was minal illnesses. “It appears that many dying of cancer in the hospital where patients feel deserted by their doctors Saunders was serving as a nurse and at the end,” she wrote. “Ideally the medical social worker. Her experience doctor should remain the center of a with Tasma convinced her that end- team who work together to relieve of-life care, especially the management where they cannot heal, to keep the of pain for terminally ill patients, was patient’s own struggle within his com- inadequate. After attending medical pass and to bring hope and consola- school she founded St. Christopher’s tion to the end.” Her criticism did not Hospice in South London in 1967, a necessarily endear her to other doc- place that she hoped would “help the tors, and pursuing her vision of better dying to live until they die and their end-of-life care meant that Saunders families to live on,” as the London frequently found herself challenging Telegraph reported. shibboleths of the medical profession. The physical alleviation of pain was As the British Medical Journal (BMJ) not Saunders’s only concern, however. noted, “She abolished the prevailing 126 ~ THE NEW ATLANTIS Copyright 2005. All rights reserved. See www.TheNewAtlantis.com for more information. A SURVEY OF TECHNOLOGY AND SOCIETY ethic that patients should be cured, Haven, Connecticut, in 1971, to start a that those who could not be cured hospice. As she grew older, honors and were a sign of failure, and that it was awards proliferated. A foundation in acceptable and even desirable to lie her name sponsors pain research, and to them about their prognosis.” As a her portrait now hangs in London’s result, she was at times a pugnacious National Portrait Gallery. opponent. As the Telegraph noted in This “grand dame and natural lead- its obituary, “Though she was widely er,” as the BMJ described her, was often revered as a sort of secular saint, it was compared to Florence Nightingale. But only through being tough and authori- in many ways Saunders’s contribution tative, and often downright difficult, was greater: While Nightingale’s pio- that she succeeded in forcing the medi- neering work improved and profes- cal profession to acknowledge what sionalized the extant job of nursing, medicine can do for the dying.” Saunders created the medical special- Saunders was also a fierce critic ty of palliative care from scratch. It of the euthanasia movement. As the would not exist without her extraor- Telegraph reported, she was the “guid- dinary vision and efforts. Millions of ing influence” behind a report issued seriously and terminally ill patients by the Church of England in 1976 around the world have benefited from about dying. “In rejecting the argu- her treatment philosophy; they have ment that chronic pain justifies eutha- spent their final moments free from nasia,” the Telegraph noted, “the report pain, surrounded by loved ones in drew attention to the fact that correct a comfortable environment. And her medical and nursing treatment can firm and morally serious position on usually remove pain or reduce it to a euthanasia continues to resonate. As minimum and can help the survivors Wesley Smith concluded in the Weekly as much as the dying.” Impending Standard, “None of this would have death is no excuse for ending life, happened had Cicely Saunders not Saunders argued; rather than rush to come to the realization that dying isn’t kill the dying in the name of ending dead: It is living, and that means no their suffering, we should focus on one should be denied dignity, love, and practical measures for alleviating their inclusion as they pass through their pain and spiritual means to make their final days. The good she did cannot be final moments worth living. measured.” Saunders devoted her entire life to When asked once how she herself the effort to improve end-of-life care hoped to die, Dame Cicely said that (she did not marry until the age of 67). she would prefer to know that she was The movement she launched eventual- dying, so that she could put her affairs ly spread to other countries, including in order, consider her spiritual obliga- the United States where she sent one tions, and have time to reflect on her of her St. Christopher’s doctors to New life. When she died of cancer in July, FALL 2005 ~ 127 Copyright 2005. All rights reserved. See www.TheNewAtlantis.com for more information. STATE OF THE ART she was indeed able to do all of this in was truly a death—and a life—with the hospice that she had created. Hers dignity until the end. 128 ~ THE NEW ATLANTIS Copyright 2005. All rights reserved. See www.TheNewAtlantis.com for more information..