Cicely Saunders

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Cicely Saunders, 2002

Dame Cicely Mary Strode Saunders , OM , DBE (born June 22, 1918 in Barnet , Hertfordshire , † July 14, 2005 in London ) was an English nurse , social worker and doctor . She is the founder of both the modern hospice movement and palliative care and is considered a pioneer in palliative medicine .

Life

Cicely Saunders was the first of three children of real estate agent Gordon Saunders and his wife Chrissie. She attended Roedean boarding school until 1937 and then began studying philosophy, politics and economics at St Anne's College, Oxford . She dropped out of college, wanting to do something more useful in the just outbreak of World War II , and trained as a nurse at St Thomas' Hospital at the Nightingale School of Nursing . After the war she returned to St Anne's College and resumed her studies, which she graduated with a degree in Public and Social Administration in 1947. Saunders, who had previously called herself an atheist, confessed to Christianity during an evangelical summer camp in 1947, which was to have a formative effect on her attitude and her further work.

She started her first job - again at St Thomas's Hospital - as a charitable carer for the Northcote Foundation, which was specifically devoted to cancer patients. In addition, she continued to work as a so-called Lady Almoner and as a volunteer in nursing. She met patients who were in the end-stage of their disease and found that they were often inadequately cared for and, above all, suffered from pain.

When she was working at St. Lukes Hospital in London in the late 1940s, she met the 40-year-old patient David Tasma in the fall of 1947. Tasma, a Polish-born Jew and survivor of the Warsaw Ghetto , suffered severe pain from advanced cancer and was accompanied by Saunders in his final weeks. He bequeathed her his £ 500 fortune with a desire to open a death center.
Realizing that Saunders needed more qualifications to achieve this goal, she decided to become a doctor. In 1957, she completed the relevant training at St Thomas's Hospital Medical School (now absorbed into King's College London ) with a Bachelor of Medicine, Bachelor of Surgery (MBBS). As early as 1959, she designed a ten-page paper on which she explained her plan, in order to spread it among friends. It was years before St. Christopher's Hospice in Sydenham in south east London opened in 1967 . ; by then, Saunders had worked as a doctor at the Sisters of Mercy hospice for seven years. From 1967 to 1985 Saunders directed St Christopher's Hospice.

Saunders got married late and had no children. She was also involved in the hospice movement in her retirement and died at the age of 87 in the hospice she had opened.

Act

Pain therapy

Towards the end of the Second World War, Saunders gained experience with nursing which, due to the poor supply situation at the time, had to do almost entirely without the possibilities of modern pharmacology. Later, she, now a social worker, observed that patients in the final stages of their cancer and their families were downright worn down by inadequately treated pain . At St Luke's Hospital, where she continued to work in nursing alongside her studies, small doses of morphine were regularly administered for such severe pain . Saunders saw the effectiveness of this move, which prompted them to conduct further research in this field.

During her medical training at St Joseph's Hospice, she introduced the pain regimen that she had learned about at St Luke's. Saunders recorded and developed the experiences and results in detail; spurred on by the positive reactions of the patients, who now suffered significantly less pain. She was able to prove that there was no basis for the common prejudices and myths in pain treatment. Until then, for example, the prevailing opinion was that morphine was addictive; Patients were not given another dose after pain medication until the pain had started again. Saunders, on the other hand, provided for a regular administration of painkillers in a dose adapted to the individual patient, so that the pain is continuously suppressed. Then systematic research into pain therapy was carried out at St Christopher's Hospice. For example, the doctor Robert Twycross Saunders, who has been employed there since 1971, was able to scientifically substantiate the fact that continuous morphine administration for pain relief does not lead to dependence or steadily decrease in effect (tolerance).

From her experience in dealing with the dying, Cicely Saunders coined the term total pain in the early 1960s . According to this concept, pain consists of four dimensions: physical, psychological, social and spiritual. Seriously ill people feel pain that goes beyond the purely physical ailment. According to Saunders, effective treatment of such pain therefore had to be multidimensional.

Hospice Care and Palliative Care

The physical, psychological, social and spiritual dimension should not only be considered in pain therapy, but also in the entire treatment and care of the dying . That is why Saunders and her colleagues founded an inpatient hospice, independent of the state health service . With Hospice care, Saunders formulated basic principles for holistic support in the last lifetime, which have been widespread under the term palliative care , especially in North America and Europe, since 1977 . The new term palliative care should make it clear that the hospice concept can and should also be implemented outside of a specially designed building; With the help of a multi-professional team, supported by volunteers , to control stressful symptoms as well as possible, and with the involvement of the family. Relatives have the opportunity to take part in caring for the sick person together with the team; on the other hand, the team is at your side if you need help before or after the patient's death. The central guiding principles are quality of life and self-determination right through to the end. Saunder's religiosity and spirituality shaped her work, but she still denied the question of whether hospice facilities always have to be based on Christianity. However, it was important to her that hospice workers could rely on a kind of philosophical-spiritual basis in order to be able to cope with this work. Medical expertise must be combined with an attitude of religious and spiritual openness. Saunders rejected euthanasia in the sense of killing on demand not only because of her Christian convictions: she assumed that good symptom control would prevent the desire for active euthanasia at all. The development of terminal care, palliative medicine and palliative care are largely thanks to Saunder's pioneering work. In Great Britain, a total of 220 hospices were built based on the model of St Christopher's by 2005 and over 8,000 inpatient hospices worldwide. Germany already had 235 inpatient hospices in 2016.

Foundation, endowment

The Cicely Saunders Institute on the Denmark Hill campus of King's College, London

Saunders realized that the hospice movement had previously focused solely on dying cancer patients. In order to open up the offers to patients suffering from other serious incurable diseases and to advance further research in palliative care, she founded the Cicely Saunders Foundation in 2002, of which she was president until her death.

Later renamed Cicely Saunders International, a fundraising campaign raised £ 10,000,000 for the new research center. The Cicely Saunders Institute opened in 2010 on the campus of King's College London ; as the first institution in the world to bring together researchers, doctors, teachers and nurses under one roof in Saunders' sense. Since 2017 the institute has been part of the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King's College.

Awards

Saunders has received numerous awards. In 1980 she was honored by Queen Elizabeth II as Dame Commander of the Order of the British Empire and thus elevated to the personal nobility . In 1989 she was accepted into the Order of Merit by Elizabeth II , also in 1989 as the only woman of the 20th century in England made an honorary doctorate in medicine (presented by the Archbishop of Canterbury ). In 2001 the hospice she founded received the Conrad N. Hilton Humanitarian Prize (endowed with 1.5 million US dollars). In 2003 Saunders was awarded the prize of honor from the Viktor Frankl Fund of the City of Vienna, and in 2004 the Ernst von Bergmann plaque from the German Medical Association. On July 3, 2005 she was awarded the University of Bath , the honorary doctorate .

Publications (selection)

  • Management of Intractable Pain. In: Proceedings of the Royal Society of Medicine, March 1963; 56 (3): 195-197. PMID 13986816
  • The nature and management of terminal pain and the hospice concept. In: Advances in Pain Research, edited by John J. Bonica and Vittorio Ventafridda; Vol 2, Raven Press, New York 1979.
  • The nature and nurture of pain control. In: Journal of Pain and Symptom Management. Volume 1, No. 4 (Herbst) 1986, pp. 199-201. PMID 3640793 .
  • Spiritual pain. In: Journal of Palliative Care. Volume 4, No. 3 (September) 1988, pp. 29-32. PMID 3183827 .
  • Living with dying. Care and medical treatment for terminally ill people. Huber, Bern / Göttingen / Toronto 1991, ISBN 3-456-82080-1 .
  • Bridge to another world. What is behind the hospice idea. Herder, Freiburg im Breisgau / Basel / Vienna 1999, ISBN 3-451-04708-X .
  • Die and live. Spirituality in Palliative Care. Theologischer Verlag, Zurich 2009, ISBN 978-3-290-17534-4 .

literature

  • Dame Cicely Saunders in the Munzinger archive ( beginning of the article freely available) In: Internationales Biographisches Archiv. 25/2003 of June 9, 2003.
  • Shirley Du Boulay, Marianne Rankin: Cicely Saunders: The Founder of the Modern Hospice Movement. SPCK 2007, ISBN 978-0-281-05889-1 .
  • Mary Campion: A hospice is born - by pioneers of the hospice movement. Attenkofer, Straubing 1997.

documentation

  • 1971: 16 days left. A death clinic in London. Reinhold Iblacker, Siegfried Braun

Web links

Individual evidence

  1. ^ German Hospice and Palliative Association eV: The hospice movement .
  2. ↑ Shirley Du Boulay: Cicely Saunders. The Founder of the Modern Hospice Movement. Hodder and Stoughton, London 1984. German translation by Barbara G. Malmsheimer: Cicely Saunders. A life for the dying. Licensed edition by Tyrolia Verlag Innsbruck for St. Benno-Verlag, Leipzig 1990, p. 9.
  3. ↑ DuBoulay 1984/1990, pp. 30-37.
  4. ↑ a b c H. Christof Müller-Busch: The beginnings - Cicely Saunders. In: Maria Wasner, Sabine Pankofer (eds.): Social work in palliative care. A manual for study and practice. Kohlhammer, Stuttgart 2014, ISBN 978-3-17-022262-5 , pp. 35-39.
  5. ↑ Dame Cicely Saunders Biography ; English, accessed April 26, 2016
  6. ^ A b c Caroline Richmond: Dame Cicely Saunders, founder of the modern hospice movement, dies. On bmj.com on July 18, 2005 ; accessed on January 15, 2019
  7. ↑ a b Cicely Saunders. A life for the hospice movement. Working group Elisabeth Kübler-Ross, hospiz.org. Retrieved February 16, 2016.
  8. ^ The hospice idea and its development. Soest hospice movement. Retrieved February 16, 2016.
  9. ↑ Martina Holder-Franz: "... that you can live to the last." Spirituality and Spiritual Care at Cicely Saunders. Theological Publishing House Zurich 2012, ISBN 978-3-290-17637-2 , p. 100.
  10. ↑ C. Saunders: The evolution of palliative care. Journal of the Royal Society of Medicine, September 2001; 94 (9): 430-432. PMCID: PMC 1282179 (free full text) PMID 11535742 ; accessed on January 16, 2019
  11. ↑ C. Saunders: Management of Intractable Pain. In: Proceedings of the Royal Society of Medicine, March 1963; 56 (3): 195-197. PMID 13986816
  12. ^ A b Andreas Heller, Sabine Pleschberger, Michaela Fink, Reimer Gronemeyer: History of the hospice movement in Germany. Der Hospiz Verlag, Ludwigsburg 2012, pp. 32–33.
  13. ↑ Michael Anderheiden, Hubert J. Bardenheuer and Wolfgang U. Eckart: Outpatient palliative medicine as a condition of an ars moriendi, Mohr Siebeck Tübingen 2008, here: Wolfgang U. Eckart : Also dying is life. Hospice and palliative medicine then and now, on Cicely Saunders p. 44, here dto: Hubert J. Bardenheuer: The Heidelberg concept of multi-professional, integrated outpatient and inpatient palliative medicine, on Cicely Saunders p. 87. ISBN 978-3-16-149897 -8th
  14. ^ John Davy, Susan Ellis: Counseling Skills in Palliative Care. Open University Press, Philadelphia 2000; P. 4
  15. ^ David AE Shepard: Principles and practice of palliative care. In: Canadian Medical Association Journal. Volume 116, Number 5, March 1977, pp. 522-526, PMID 65206 , PMC 1879355 (free full text).
  16. ↑ DuBoulay 1984/1990, pp. 30-37 and 146-164.
  17. ↑ Numbers and facts. German Hospice and Palliative Association . Retrieved November 15, 2016.
  18. ↑ Dame Cicely Saunders Biography ; English, accessed August 8, 2019
  19. ^ History of the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care (English) ; accessed on August 7, 2019
personal data
SURNAME Saunders, Cicely
ALTERNATIVE NAMES Saunders, Cicely Mary Strode
BRIEF DESCRIPTION English doctor
DATE OF BIRTH June 22, 1918
PLACE OF BIRTH Barnet , Hertfordshire
DATE OF DEATH July 14, 2005
Place of death London