Cicely Saunders Dies At 87; Reshaped End-of-Life Care [Новость добавлена - 09.04.2009]

By Wolfgang Saxon, The New York Times UK, August 4, 2005

Dame Cicely Saunders, a founder of the modern hospice movement, died July 14 in the prototype she had built in Britain 38 years ago, St. Christopher's in Sydenham, south London. She was 87. 

European hospices go back to the Middle Ages, when they sheltered, comforted and entertained wayfarers - pilgrims, minstrels, crusading knights. Dame Cicely, a medical doctor, played a major role in reinventing them as last way stations for the terminally ill, offering palliative care and, if possible, peace of mind before a death without needless pain.

She founded the hospice at St. Christopher's in 1967 and made it the kernel of a movement that she helped spread in the United States and worldwide. Its purpose was to complement pain and symptom control with compassionate care.

Now caring for more than 2,000 patients and their families a year, St. Christopher's has inspired about 240 other hospices in Britain alone and many others around the world. It supports hospice care in developing countries and shares expertise through international partnerships and extensive education, training and research programs. Over the years it has trained some 50,000 doctors, nurses and other professionals and helped establish palliative care for those with terminal illnesses as a medical discipline. 

Dame Cicely was St. Christopher's medical director from its founding in 1967 until 1985, then served as chairwoman till 2000, when she took the title of president. 

Her travels in the United States greatly encouraged the movement here, said Patricia Farrington, director of the Pax Christi Hospice program at St. Vincent Catholic Medical Centers in New York. 

"She came to us in the early 60's and met with people here who became hospice founders and pioneers," she said. "She came to New York, Los Angeles and Boston and Yale, and met with people who had corresponded with her and were impressed with her passion, that it was the obligation of health-care providers to relieve suffering."

Dame Cicely's first book, "Care of the Dying," was published in 1960. She wrote and edited textbooks and guides for laymen bracing for a death in the family. Among the titles were "Living with Dying" (1983) ; "Management of Terminal Malignant Disease" (Oxford, third edition, 1993), written with Nigel Sykes; and "Living With Dying: A Guide to Palliative Care" (third edition, 1995), to which she contributed.

She received more than a score of honorary degrees and was made a Dame Commander of the British Empire in 1980. She was awarded Britain's Order of Merit in 1989. 

Cicely Mary Strode Saunders was born into a well-to-do family on June 22, 1918, in Barnet, in north London. She set out to study politics, philosophy and economics at Oxford, but with the war she turned to tending to the ill and wounded. She graduated as a Red Cross war nurse from the Nightingale Training School in 1944 and worked in many hospital departments. 

Returning to St. Anne's College at Oxford, she studied to become a medical social worker, or what the British then called a lady almoner. She trained at a cancer hospital and, having joined the staff, developed a rapport with patients. Talking with them, she saw the need for better-rounded care of those near the end.

She entered St. Thomas's Hospital Medical School, became a doctor in 1957 and, as a researcher in pharmacology, worked on handling pain. She sought a way to avoid large dosages of medications like morphine by giving low dosages regularly, allowing the patient to stay alert.

As early as 1959 she presented her ideas for a holistic hospice in a paper titled "The Need" that drew contrasts with prevailing treatments of the terminally ill. In another paper, "The Scheme," she outlined a plan for a 100-bed home. 

Dame Cicely, a Christian, included a chapel and provided for prayer time but made it clear that religion, even when proffered tactfully, was no substitute for clean, well-lighted rooms, a comfortable day room, a homelike setting and a caring staff. 

The home within a hospital that she had envisioned, St. Christopher's Hospice, finally opened in 1967 after she led a fund-raising campaign for it. 

"I didn't set out to change the world, I set out to do something about pain," Dame Cicely said in a 2002 interview with The Daily Telegraph of London. "It wasn't long before I realized that pain wasn't only physical, but it was psychological and spiritual." 

In 1980, Dame Cicely married Marian Bohusz-Szyszko, a Polish artist. He died in her care at St. Christopher's in 1995.