In celebration of International Women’s Day, PDC Rx would like to honor Dame Cicely Saunders, the founder of today’s version of hospice and palliative care for the terminally ill.  Dr. Saunders was a London physician who began her work with the terminally ill in 1947.  In 1957, she earned her medical degree, and in 1967 she founded St. Christopher’s Hospice in south west London.   According to the BMJ (formerly the British Medical Journal), she is responsible for introducing the concept that people who are facing end-of-life illnesses need to be treated with dignity, compassion, and respect.  She helped abolish the gloomy belief that succumbing to a terminal illness meant that the patient has failed to conquer it.  She is also responsible for abandoning the practice of lying to the terminally ill about their progress. 

According to the BMJ, Dame Cicely Saunders introduced the idea of “total pain,” which refers to “the physical, emotion, social, and spiritual dimensions of distress.”  Prior to Saunders’ entrance into the world of palliative care, the dying patient was subjected to long hours without pain treatment, extremely limited visitation, and few, if any, attempts to ease distress. 

Early in her career, Saunders worked as an almoner, a chaplain or church officer.  It was during this time that she cared for a dying 40 year old named David Tasma.  She and Tasma developed a deep relationship, and often discussed the idea that she should create a home for dying people so that they could find peace and comfort in their final days.  Tasma left her 500 pounds, a significant amount of money in the 1940s, to found St. Christopher’s Hospice (named for the patron saint of travelers).  Tasma said to her, “I’ll be a window in your home.”  Interestingly, in St. Christopher’s Hospice there is now a window dedicated to David Tasma.

Tasma’s death was not the only one that helped Saunders’ develop her determination to change the course of action for dying people.  His death coincided with that of her father’s and of another close friend.  Saunders fell into a deep state of depression that she referred to as “pathological grief,” but she emerged with a newfound philosophy that “scientific knowledge should be combined with care and love” (BMJ).

In 1963 (four years prior to opening St. Christopher’s Hospice), in a presentation to doctors, nurses, chaplains, and medical students at Yale University, Dr. Saunders shared documentation verifying that patients who received specialized hospice care experienced a significantly improved end of life.  She showed the audience pictures of patients who were terminally ill with cancer before and after receiving palliative care rather than treatments meant to cure.  The difference in the patients’ appearance and apparent overall wellbeing was remarkable.   

Since the 11th century, the word hospice has been used as a noun that means a home that provides care for the terminally ill.  It is derived from the archaic term suggesting some sort of lodging for weary travelers, often a lodge that is operated by a religious order.  Today, thanks to Dame Cecily Saunders, when we use the term hospice, we are referring to an organization that provides care primarily when treatment for a life-limiting illness has stopped because it has been determined that it is unlikely that the patient will survive.  The hospice can palliate, can make a disease or condition less severe or unpleasant.  The term palliative is derived from a Latin verb meaning to clock or disguise.  Therefore, palliative care eases the symptoms without curing the disease itself but certainly may enhance the healing process.

PDC Rx Contributor: Joanna Rasp