Editing Cicely Saunders

{{Short description|English nurse, social worker, physician and writer}}
{{Use dmy dates|date=February 2019}}
{{Use British English|date=February 2019}}
{{Infobox person
| honorific-prefix   = 
| name               = Dame Cicely Saunders
| honorific_suffix   = {{postnominals|country=GBR|OM|DBE|FRCS|FRCP|FRCN|size=100%}}
| image              = EWS21.13.jpg
| caption            = Saunders in 2002
| birth_name         = Cicely Mary Strode Saunders<ref name="birth">''England & Wales, Civil Registration Birth Index, 1916–2007''</ref><ref name="death">''England and Wales, Death Index, 1989–2018''</ref>
| birth_date         = {{birth date|df=yes|1918|6|22}}
| birth_place        = [[Chipping Barnet|Barnet]], [[Hertfordshire]], England
| death_date         = {{death date and age|df=yes|2005|7|14|1918|6|22}}
| death_place        = [[Bromley, London]], England
| alma_mater         = [[St Thomas's Hospital Medical School]]<br/>[[St Anne's College, Oxford]]
| occupation         = {{hlist|Nurse|social worker|physician|writer}}
| known_for          = [[hospice care|Hospice care movement]], Founder of [[St Christophers Hospice]]
| spouse             = {{marriage|Marian Bohusz-Szyszko|1980|1995|end=died}}
}}
'''Dame Cicely Mary Strode Saunders''' (22 June 1918 – 14 July 2005) was an English nurse, social worker, physician and writer. She is noted for her work in terminal care research and her role in the [[Hospice#Rise of the modern hospice movement|birth of the hospice movement]], emphasising the importance of [[Palliative care#History|palliative care]] in modern medicine, and opposing the legalisation of [[voluntary euthanasia]].

==Early life and education==
Saunders was born in [[Chipping Barnet|Barnet]], Hertfordshire, to Philip Gordon Saunders, a chartered surveyor and landowner, and to Mary Christian Knight.<ref name="birth"/> She had two younger brothers, John Frederick Stacey Saunders and Christopher Gordon Strode Saunders.<ref name="register">''[[1939 England and Wales Register]]''</ref>

After attending [[Roedean School]] (1932–37), Saunders began studying politics, philosophy, and economics at [[St Anne's College, Oxford]] in 1938. During the war, she decided to become a nurse and trained at [[Nightingale School of Nursing]] based at [[St Thomas's Hospital]] from 1940 to 1944.<ref name="stchristophers.org.uk">{{cite web|url=http://www.stchristophers.org.uk/about/damecicelysaunders|title=Dame Cicely Saunders |work=St. Christopher's}}</ref><ref name="Biography">{{Cite web|url=https://cicelysaundersinternational.org/dame-cicely-saunders/|title=Biography|website=Cicely Saunders International|language=en-GB|access-date=2019-05-09}}</ref> Returning to St Anne's College after a back injury in 1944, she took a [[Bachelor's degree|BA]] in 1945, qualifying as a medical social worker in 1947 and eventually trained as a doctor at [[St Thomas's Hospital Medical School]] (now merged to form [[King's College London GKT School of Medical Education]]) and qualified [[MBBS]] in 1957.<ref name="stchristophers.org.uk"/>

==Relationships==
In 1948, Saunders fell in love with a patient, Ela Majer "David" Tasma, a Polish-Jewish refugee who, having escaped from the [[Warsaw Ghetto]], worked as a waiter; he was dying of [[cancer]]. He bequeathed her £500 ({{Inflation|UK|500|1948|r=-3|fmt=eq|cursign=£}})<ref name="probate">''England & Wales, National Probate Calendar (Index of Wills and Administrations), 1858–1995''</ref> to be "a window in your home".<ref>{{cite web|url=http://www.bbc.co.uk/programmes/p0093qyn |title=BBC Radio 4 – Desert Island Discs, Dame Cicely Saunders |publisher=Bbc.co.uk |access-date=2018-12-19}}</ref> This donation, which helped germinate the idea that would become St Christopher's Hospice, Sydenham, London, is memorialized with a plain sheet of glass at the hospice's entrance.

While training for [[social work]], she holidayed with some Christians and was converted to Christianity.<ref name=":1" /> In the late 1940s, Saunders began working part-time at [[St Luke's Home for the Dying Poor]] in [[Bayswater]], and it was partly this which, in 1951, led her to begin studying to become a physician.

==Hospice==
A year later, she began working at St Joseph's Hospice, a Catholic establishment in [[London Borough of Hackney|Hackney, East London]], where she would remain for seven years, researching pain control. There she met a second [[Polish people|Pole]], Antoni Michniewicz, a patient with whom she fell in love. His death, in 1960, coincided with the death of Saunders's father in 1961, and another friend, and put her into what she later called a state of "pathological grieving".<ref name=":1" /> But she had already decided to set up her own hospice, serving cancer patients, and said that Michniewicz's death had shown her that "as the body becomes weaker, so the spirit becomes stronger".<ref>{{cite news |title=Dame Cicely Saunders, OM |url=https://www.telegraph.co.uk/news/obituaries/1494039/Dame-Cicely-Saunders-OM.html |access-date=22 June 2018 |work=The Telegraph |date=15 Jul 2005}}</ref>

Saunders said that after 11 years of thinking about the project, she had drawn up a comprehensive plan and sought finance after reading Psalm 37: "Commit thy way unto the Lord; trust also in him; and he shall bring it to pass." She succeeded in engaging the support of [[Albertine Winner]], the deputy chief medical officer at the Ministry of Health at the time. Later, as Dame Albertine Winner, she served as chair of St Christopher's. In 1965, Saunders was appointed [[Officer of the Order of the British Empire]].
[[File:St. Christopher's Hospice.jpg|thumb|St Christopher's Hospice, Sydenham, London]]
In 1967, [[St Christopher's Hospice]], the world's first purpose-built hospice, was established.<ref name=":1" /> The hospice was founded on the principles of combining teaching and clinical research, expert [[pain]] and symptom relief with [[holistic health|holistic]] care to meet the physical, social, psychological and spiritual needs of its patients and those of their family and friends.<ref name=":1" /> St Christopher's Hospice was developed based on a care philosophy that "you matter because you are you, you matter to the last moment of your life",<ref>{{Cite journal|last=Brignall|first=Irene|date=2003|title=You Matter To The Last Moment Of Your Life|journal=BMJ: British Medical Journal|volume=326|issue=7402|pages=1335|issn=0959-8138|jstor=25454749|doi=10.1136/bmj.326.7402.1335|pmid=12805195|pmc=1126212}}</ref> an approach requiring specialist care which led to a new medical specialty – [[palliative care]] – that could be adapted to different situations. Research shows that St Christopher's was quite different from hospitals in the 1960s, designed and managed as a "home from home" where the physical environment was important.<ref>{{Cite journal|last1=West|first1=Emily|last2=Onwuteaka-Philipsen|first2=Bregje|last3=Philipsen|first3=Hans|last4=Higginson|first4=Irene J.|last5=Pasman|first5=H. R. W.|date=14 Jan 2017|title="Keep All Thee 'Til the End": Reclaiming the Lifeworld for Patients in the Hospice Setting|journal=OMEGA - Journal of Death and Dying|language=en|volume=78|issue=4|pages=390–403|doi=10.1177/0030222817697040|pmid=29284311|s2cid=35472482|issn=0030-2228}}</ref> It was a place where patients could garden, write, talk – and get their hair done. There was always, Saunders would emphasize, so much more to be done, and she worked in this spirit as its medical director from 1967, and then, from 1985, as its chairperson, a post she occupied until 2000 when she became president.<ref name=":0">{{Cite web|url=https://cicelysaundersinternational.org/dame-cicely-saunders/|title=Work Life|website=Cicely Saunders International|language=en-GB|access-date=2019-05-09}}</ref>

She was, however, reluctant for St Christopher's to admit patients with [[AIDS]] in the years after the syndrome first emerged. In a letter to the [[Norman Fowler, Baron Fowler|Secretary of State for Social Services]], she stated, "we have strong reservations about the use of our existing inpatient facilities for AIDS patients", explaining in a memorandum to the [[Select committee (United Kingdom)|Select Committee]] on Social Services: "A hospice ward is a very personal place, welcoming families, with their children, to be with the dying family member. Among them, I believe, there would be many who would extremely fearful of doing this if they knew AIDS patients were being admitted. However irrational, this fear is a very real matter, and would be an added burden on those facing the loss of loved ones."<ref>•	{{Cite Hansard|house=House of Commons |title=St. Christopher's Hospice |url=https://hansard.parliament.uk/commons/1987-02-19/debates/a9fb2af2-53b5-4485-bdd7-c5c05e89d971/StChristopherSHospice#1150|date=February 19, 1987 |column_start=1150 |column_end=1151}}</ref>

Saunders was an Anglican. In 1977, she was awarded an honorary [[Lambeth degree|Lambeth doctorate]] by the Archbishop of Canterbury. She later was made a Dame of the [[Order of St. Gregory the Great|Order of St Gregory the Great]] (awarded by the Pope)<ref>{{Cite web|url=https://cicelysaundersinternational.org/dame-cicely-saunders/|title=Work Life|website=Cicely Saunders International|language=en-GB|access-date=2019-05-09}} {{verify source |date=September 2019 |reason=This ref was deleted Special:Diff/896348478 by a bug in VisualEditor and later restored by a bot from the original cite located at Special:Permalink/896347907 cite #8 - verify the cite is accurate and delete this template. [[User:GreenC bot/Job 18]]}}</ref>

In 1979, she was appointed [[Dame Commander of the Order of the British Empire]] (DBE). In 1981 she was awarded the [[Templeton Prize]], the world's highest-value annual prize awarded to an individual. In 1989, she was appointed to the [[Order of Merit]]. In 2001, she received the world's largest humanitarian award, the [[Conrad N. Hilton Humanitarian Prize]], on behalf of St Christopher's.

On 25 April 2005, another portrait of Saunders was unveiled at the [[National Portrait Gallery (London)|National Portrait Gallery]].<ref>{{Cite web |url=http://www.npg.org.uk/live/wocicelysaunders.asp |title=National Portrait Gallery &#124; What's on? &#124; Dame Cicely Saunders |access-date=16 July 2005 |archive-url=https://web.archive.org/web/20051214193303/http://www.npg.org.uk/live/wocicelysaunders.asp |archive-date=14 December 2005 |url-status=dead |df=dmy-all }}</ref> Saunders was one of the subjects of Prime Minister [[Gordon Brown]]'s book: ''[[Courage: Eight Portraits]]''.<ref>{{Citation |last= Brown |first= Gordon |author-link= Gordon Brown |title= Courage: Eight portraits |place= London |publisher= Bloomsbury Publishing Plc |year= 2007 |chapter= Cicely Saunders |isbn=978-0747565321}}</ref> She was a [[Royal College of Physicians|Fellow of the Royal College of Physicians]], a [[Royal College of Nursing|Fellow of the Royal College of Nursing]] and a [[Royal College of Surgeons of England|Fellow of the Royal College of Surgeons]].

St Christopher's includes an arts team that provides art therapy, music therapy, drama therapy and community arts. The work of the arts team is reflected in two publications: ''End of Life Care: A Guide for Therapists, Artists and Arts Therapists'' and ''The Creative Arts in Palliative Care''.<ref>{{cite book|url=https://books.google.com/books?id=gXcQAgAAQBAJ&q=nigel+hartley&pg=PP1|title=End of Life Care|isbn=9780857003362|last1=Hartley|first1=Nigel|date=2013-11-21|publisher=Jessica Kingsley Publishers }}</ref><ref>{{cite book|url=https://books.google.com/books?id=AE1Z6rbii0QC&q=nigel+hartley&pg=PA4|title=The Creative Arts in Palliative Care|isbn=9781846428029|last1=Hartley|first1=Nigel|last2=Payne|first2=Malcolm|date=2008-05-15|publisher=Jessica Kingsley Publishers }}</ref>

==Marriage==
In 1963, three years after the death of Michniewicz, Saunders became familiar with the paintings of [[Marian Bohusz-Szyszko]], a Polish émigré and professor with a degree in fine art. They met and became friends, and she became a patron of his art. A substantial amount of his work is hung at St Christopher's Hospice.

Bohusz-Szyszko had a long-estranged wife in [[Poland]], whom he supported, and was a devout [[Roman Catholic]]. In 1980, five years after the death of his wife, he married Saunders. She was 61 and he was 79. Bohusz-Szyszko died in 1995, at the age of 94, spending his last days at St Christopher's Hospice.<ref name=":1">{{cite journal|url=http://www.bmj.com/content/suppl/2005/07/18/331.7509.DC1|title=Dame Cicely Saunders, founder of the modern hospice movement, dies|website=British Medical Journal (obituary)|date=25 December 2016|access-date=18 June 2021}}</ref>

==Charitable organisation==
{{more citations needed|section|date=May 2019}}
In 2002, Saunders co-founded a new charitable organisation, Cicely Saunders International, of which she was the founding trustee and president.<ref name="Biography"/> The charity's mission is to promote research to improve the care and treatment of all patients with progressive illness and to make high-quality palliative care available to everyone who needs it – hospice, hospital or home. The charity has co-created the world's first purpose built institute of palliative care – the Cicely Saunders Institute, and supported research to improve the management of symptoms such as breathlessness,<ref>{{Cite web|url=https://www.kcl.ac.uk/cicelysaunders/research/symptom/breathlessness|title=King's College London - Breathlessness|website=www.kcl.ac.uk|language=en-GB|access-date=2019-05-09|archive-date=9 May 2019|archive-url=https://web.archive.org/web/20190509215940/https://www.kcl.ac.uk/cicelysaunders/research/symptom/breathlessness|url-status=dead}}</ref> action to meet more closely patient and family choice in palliative care and better support for older people. Cicely Saunder's obituary in the Royal College of Physicians of London's Munk's Roll collection contains further information about her work with this organisation.<ref>{{Cite web|url=http://munksroll.rcplondon.ac.uk/Biography/Details/5463|title=Munks Roll Details for Cicely Mary Strode (Dame) Saunders|website=munksroll.rcplondon.ac.uk|access-date=2019-01-15|archive-date=30 May 2013|archive-url=https://web.archive.org/web/20130530071321/http://munksroll.rcplondon.ac.uk/Biography/Details/5463|url-status=dead}}</ref>

==Medical ethics==
Saunders was instrumental in the history of UK [[medical ethics]]. She was an advisor to Andrew Mephem whose report led the Rev. [[Edward Shotter]] to set up the [[London Medical Group]] (LMG), a forerunner of the Society for the Study of Medical Ethics, later the Institute of Medical Ethics. She gave one of the first LMG lectures on the subject of pain, developing the talk into "The Nature and Management of Terminal pain" by 1972.<ref name=reynolds>Reynolds, L.A., and E.M. Tansey, eds. ''Medical Ethics Education in Britain, 1963–1993''. London: [http://eprints.ucl.ac.uk/14885 Wellcome Trust Centre for the History of Medicine at UCL] {{webarchive|url=https://web.archive.org/web/20140325191214/http://eprints.ucl.ac.uk/14885/ |date=25 March 2014 }} (2007), pp. 8, 77, 118.</ref>

This went on to be one of the most often repeated and requested lectures of the LMG and other such Medical Groups that sprung up around Great Britain, where it was often given as their inaugural lecture.<ref name=reynolds/> Her talk on the care of the dying patient was printed by the LMG in its series 'Documentation in Medical Ethics, a forerunner of the Journal of Medical Ethics.<ref>Saunders, Cicely. ''The Care of the Dying Patient and His Family''; documentation in Medical Ethics, no. 5 (1975), published by the London Medical Group.</ref>

She strongly opposed [[voluntary euthanasia]]. This was partly because of her Christian faith, but she also argued that it is never needed, because effective pain control is always possible. She did, however, accept that both sides in the euthanasia debate were against unnecessary pain and the loss of personal dignity.<ref name=":1" />

==Total pain==
Saunders introduced the idea of "total pain", which included physical, emotional, social, and [[spiritual distress]].<ref>{{cite journal |title=Dame Cicely Saunders |first=Caroline |last=Richmond |journal=BMJ |date=23 July 2005 |volume=331 |issue=7510 |page=238 |doi=10.1136/bmj.331.7510.238 |pmc=1179787}}</ref><ref>{{cite journal |title=Elsevier |doi=10.1016/j.jpainsymman.2004.08.008 |pmid = 15652434|volume=29 |issue = 1|journal=Journal of Pain and Symptom Management |pages=2–13|year=2005 |last1=Seymour |first1=Jane |last2=Clark |first2=David |last3=Winslow |first3=Michelle |doi-access=free }}</ref><ref>{{cite journal|title=The evolution of palliative care |date=25 March 2013 |pmc=1282179 |pmid=11535742 |volume=94 |issue=9 |journal=J R Soc Med |pages=430–432 | last1 = Saunders | first1 = C|doi=10.1177/014107680109400904 }}</ref><ref>{{cite journal | last1 = Clark | first1 = D | year = 2000 | title = Total pain: the work of Cicely Saunders and the hospice movement | journal = American Pain Society Bulletin | volume = 10 | issue = 4| pages = 13–15 }}</ref><ref>{{cite web|url=https://www.nursingtimes.net/clinical-archive/pain-management/a-holistic-approach-to-pain-23-08-2001/ |title=A holistic approach to pain|work=Nursing Times|date=23 August 2001 }}</ref>

==Death==
Saunders developed breast cancer but still continued to work. She died aged 87 in 2005 at St Christopher's Hospice.<ref>{{cite news|url=https://www.nytimes.com/2005/07/31/obituaries/cicely-saunders-dies-at-87-reshaped-endoflife-care.html|title=Cicely Saunders Dies at 87; Reshaped End-of-Life Care|last=Saxon|first=Wolfgang|date=July 31, 2005|work=[[The New York Times]]|access-date=June 22, 2018}}</ref>

==Biographies==
She is the subject of a biography, ''Cicely Saunders: A Life and Legacy'', published in 2018 to mark the 100th anniversary of her birth, and of the biographical novel ''Di cosa è fatta la speranza. Il romanzo di Cicely Saunders'' by Emmanuel Exitu, published in Italy by [[Bompiani|Bompiani editore]].

==Honours==
* Member of the Order of Merit ([[Order of Merit|OM]])<ref name=":2">{{Cite web|title=Remembering Dame Cicely Saunders: Founder of Hospice|url=https://www.crossroadshospice.com/hospice-palliative-care-blog/2017/july/13/remembering-dame-cicely-saunders-founder-of-hospice/|access-date=2020-10-04|website=www.crossroadshospice.com}}</ref>
* Dame Commander of the Order of the British Empire ([[Dame Commander of the Most Excellent Order of the British Empire|DBE]])<ref name=":2" />
* Fellow of the Royal College of Surgeons ([[FRCS]])
* Fellow of the Royal College of Physicians ([[Fellow of the Royal College of Physicians|FRCP]])
* Fellow of the Royal College of Nursing ([[Fellow of the Royal College of Nursing|FRCN]])
* Dame of the Order of St Gregory the Great (awarded by the Pope)<ref name=":0" />

== See also ==
* [[Thelma Bates (physician)|Thelma Bates]], the oncologist who established Britain's first hospital-based palliative care service and worked with Saunders

==References==
{{reflist}}

==Further reading==
* {{cite book|last=du Boulay|first= Shirley|date=1984|title= Cicely Saunders: The Founder of the Modern Hospice Movement|location= London|publisher= Hodder and Staunton|isbn=0-340-3510 3-9}}
* {{cite book|last=Brown|first= Gordon|date=2007|title= Courage: Eight Portraits|location= London|publisher= Bloomsbury|isbn=978-0747565321}}
* {{cite book|last=Clark|first= David|date=2018|title= Cicely Saunders: A Life and Legacy|location= New York and Oxford|publisher= Oxford University Press|isbn=978-0190637934}}
* Wood, J. A. (2021). "Cicely Saunders and the legacies of ‘Total Pain’". PhD thesis, University of Glasgow. https://theses.gla.ac.uk/82450/

==External links==
* {{NPG name}}
* [http://bmj.bmjjournals.com/archive/7072iv1.htm A personal therapeutic journey, Cicely Saunders British Medical Journal 1996]
* [http://www.cicelysaundersfoundation.org/ Cicely Saunders International]
* [http://www.bbc.co.uk/radio4/womanshour/2001_33_fri_03.shtml BBC Woman's Hour interview and history, broadcast 17 August 2001]
* [http://www.bbc.co.uk/programmes/p0093qyn Appearance on Desert Island Discs 10 February 1995]

{{Templeton Prize Laureates}}
{{Authority control}}

{{DEFAULTSORT:Saunders, Cicely}}
[[Category:1918 births]]
[[Category:2005 deaths]]
[[Category:People educated at Roedean School, East Sussex]]
[[Category:Alumni of St Anne's College, Oxford]]
[[Category:Alumni of King's College London]]
[[Category:Alumni of St Thomas's Hospital Medical School]]
[[Category:British social workers]]
[[Category:Dames Commander of the Order of the British Empire]]
[[Category:English Anglicans]]
[[Category:Nurses from London]]
[[Category:English medical writers]]
[[Category:Women medical writers]]
[[Category:Holders of a Lambeth degree]]
[[Category:Fellows of the Royal College of Surgeons of England]]
[[Category:Fellows of the Royal College of Physicians]]
[[Category:Converts to Christianity]]
[[Category:Deaths from cancer in England]]
[[Category:Honorary Fellows of the Royal College of Nursing]]
[[Category:Members of the Order of Merit]]
[[Category:British public health doctors]]
[[Category:People from Chipping Barnet]]
[[Category:Templeton Prize laureates]]
[[Category:British palliative care physicians]]
[[Category:British women public health doctors]]
[[Category:Writers from the London Borough of Barnet]]