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The Time After 1945

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A History of Palliative Care, 1500-1970

Part of the book series: Philosophy and Medicine ((PHME,volume 123))

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Abstract

Summarizing extant research and drawing on new unpublished and printed material as well, this chapter outlines the renaissance of palliative medicine and terminal care after World War II. Responding to the particular needs of dying patients (and their families), which authors like Elisabeth Kübler-Ross had brought to the fore, Cicely Saunders, Balfour Mount and many others created hospices for the dying, palliative care centers within hospitals and out-patient services for terminally ill patients. Based on a multidisciplinary approach and combining the best possible medical treatment of pain and other symptoms with emotional and spiritual care, they developed the model of “total care” which is still at the heart of palliative medicine today.

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Notes

  1. 1.

    Field, Palliative medicine (1994).

  2. 2.

    David A. E. Shepard, Terminal care: towards an ideal, in: CMA Journal 115 (1976), pp. 97–8.

  3. 3.

    Paul Vogler, Hospitalitenkrankenhäuser, in: idem and Gustav Hassenpflug (eds), Handbuch für den Neuen Krankenhausbau, Munich−Berlin: Urban & Schwarzenberg 1951, pp. 36–41, here p. 37.

  4. 4.

    A cursory look of the titles shows the range of issues approached: The act of dying (1948), Dying of cancer (1949), Care of the dying (1952), Psychosocial aspects of cancer: professional attitudes and terminal care (1952), The use of heroin in therapeutics (1953), Case work in terminal illness (1954), Integrated services for the terminally ill cancer patient and his family (1956), The patient with incurable cancer (1956), Psychotherapy for the dying (1957), Care of the dying (1957), On death (1958), The dying (1959), Care of the dying (1959), Nursing the late cancer patient at home. The family’s impressions (1959), A survey of the social needs of patients with incurable lung cancer (1959), The management of cases in the terminal stages of malignant disease (1959), The meaning of death (1959).

  5. 5.

    Cicely Saunders also credited Kübler-Ross’ work with great influence on the developments in the US; the two met for the first time in 1966, at Yale University; cf. Historical Library of the Medical School, Yale University, New Haven, Grace Goldin collection, Cicely Saunders, Hints about the story of St. Christopher’s, typescript, dated in handwriting spring 1979 (in what follows: Saunders, Hints (typescript)).

  6. 6.

    Kübler-Ross, On death (1969), pp. 6–7.

  7. 7.

    Ibid., p. 7.

  8. 8.

    Ibid., p. 8.

  9. 9.

    Illich, Limits (1977).

  10. 10.

    Seminal contributions were Barney G. Glaser and Anselm L. Strauss, Awareness of dying, Chicago: Aldine 1965; Herman Feifel, Perception of death, in: Annals of the New York Academy of Sciences 164 (1969), pp. 669–77; Kübler-Ross, On death (1969); Ann Cartwright, Lisbeth Hockey and John L. Anderson, Life before death, London: Routledge & Kegan Paul 1973; in more recent times numerous publications have approached this issue; see e.g. Elsbeth Voogt et al., Attitudes of patients with incurable cancer toward medical treatment in the last phase of life, Journal of clinical oncology 23 (2005), pp. 2012–19; on the experiences of the relatives see e.g., A. Perreault, F. Fothergill-Bourbonnais and V. Fiset, The experience of family members caring for a dying loved one, in: International journal of palliative nursing 10 (2004), pp. 133–43; on the nurses’ perspective see e.g., Nicholas Eschenbruch, Nursing stories. Life and death in a German hospice, New York: Berghahn 2007; on the wishes and expectations among the general public see e.g., Judith A. C. Rietjens et al., Preferences of the Dutch general public for a good death and associations with attitudes towards end-of-life decision-making, in: Palliative medicine 20 (2006), pp. 685–92.

  11. 11.

    See the seminal work by Hawkins, Reconstructing illness (1993), esp. pp. 91–124 and the fairly recent survey by Jane E. Schultz and Martha Stoddard Holmes (eds), Cancer stories (= Literature and medicine 28/2), Baltimore–London: Johns Hopkins University Press 2010; see also Moamai, Krebs schreiben (1997); Stéphane Grisi, Dans l’intimité des maladies. De Montaigne à Hervé Guibert, Paris: de Brouwer 1996; on autobiographical writings by AIDS-patients see Beate Schappach, “Es war als hätte das Virus mich geschwängert”. Vertextungsformen in AIDS-Autobiographien, in: Philipp Osten (ed.), Patientendokumente. Krankheit in Selbstzeugnissen. Stuttgart: Steiner 2010, pp. 143–59.

  12. 12.

    Harold Brodkey, This wild darkness. The story of my death, London: Holt 1988, p. 153.

  13. 13.

    Frank, At the will of the body (1991), p. 1.

  14. 14.

    Fritz Zorn, Mars, Munich: Kindler 1977.

  15. 15.

    Thorwald Dethlefsen, Schicksal als Chance. Esoterische Psychologie, das Urwissen zur Vollkommenheit des Menschen, Munich: Bertelsmann 1979, cit. p. 146; idem and Rüdiger Dahlke, Krankheit als Weg. Deutung und Be-deutung der Krankheitsbilder, Munich: Bertelsmann 1983.

  16. 16.

    Sontag, Illness (1978).

  17. 17.

    In AIDS-(auto)pathography the quest for meaning can go hand in hand with the question of guilt, the guilt of the one by whom the patient was infected as well as the guilt of the patient himself who may already have transmitted the virus to others; cf. Hélène Laygues, SIDA. Témoignage sur la vie et la mort de Martin, Paris: Hachette 1985.

  18. 18.

    This is a major theme, e.g., in Aleksandr Isaevič Solženizyn, Cancer ward, London: Bantam Books 1968; see also Huldrych M. Koelbing, Medizin, Arzt und Patient in Solschenizyns “Krebsstation”, Zürich: Juris 1973.

  19. 19.

    Arthur W. Frank. Tricksters and truth tellers: Narrating illness in an age of authenticity and appropriation, in: Jane E. Schultz and Martha Stoddard Holmes (eds), Cancer stories (= Literature and medicine vol. 28, n° 2), Baltimore − London: Johns Hopkins University Press 2010, pp. 185–99; see e.g., Audre Lorde, The cancer journals (special edition), San Francisco: aunt lute books 1997.

  20. 20.

    Noll, Diktate (1984).

  21. 21.

    Saunders, Hints (typescript); see also eadem, A personal therapeutic journey, in: British medical journal 313 (1996), pp. 1599–1601; eadem, The evolution of palliative care, in: Journal of the Royal Society of Medicine 94 (2001), pp. 430–2; for a detailed biography see Du Boulay, Cicely Saunders (1984).

  22. 22.

    Saunders, Management (1967).

  23. 23.

    Ibid., pp. 5–10.

  24. 24.

    Ibid., pp. 13–20.

  25. 25.

    Ibid., pp. 21–5.

  26. 26.

    Goldin, A protohospice (1981), p. 393.

  27. 27.

    Historical Library of the Medical School, Yale University, New Haven, Grace Goldin collection, typescript travel account by Sylvia Lack. This account stands at the centre of a medical dissertation Anna Mauerhöfer, Würzburg, is in the process of completing.

  28. 28.

    See also Clark, From margins (2007), p. 433.

  29. 29.

    In actual practice, however, the home also accepted patients with longstanding cancer, who needed special medical and nursing care.

  30. 30.

    Cf. Clark, From margins (2007), p. 432.

  31. 31.

    For overviews of the development of palliative care services in the first decades see Hayley and Sachs, A brief history (2005), and, for North America, Britain, Australia and New Zealand Lewis, Medicine (2007), pp. 121–158.

  32. 32.

    Overview in Siebold, Hospice movement (1992).

  33. 33.

    Connor, Development (2007).

  34. 34.

    Historical Library of the Medical School, Yale University, New Haven, Grace Goldin collection, typescript travel account by Sylvia Lack (around 1974).

  35. 35.

    Klaschik and Nauck, Historische Entwicklung (1998), p. 622.

  36. 36.

    Balfour M. Mount, The Royal Victoria Hospital Palliative Care Service. A Canadian experience, in: Cicely Saunders and Robert Kastenbaum (eds): Hospice care on the international scene, New York: Springer 1997, pp. 73–85.

  37. 37.

    Osler Library, McGill University, Montreal, Royal Victoria Hospital, Montreal. Palliative care service/Service de soins palliatifs. Pilot project/Projet pilot, Jan. 1975 − Jan. 1977, Montreal 1976 (typescript.), preface and summary, pp. 59–60.

  38. 38.

    Ibid., preface by Balfour M. Mount.

  39. 39.

    Ibid.

  40. 40.

    Ibid., esp. p. 35 (see also Ajemian and Mount, R.V.H. manual (1980)).

  41. 41.

    Ibid., p. 36 (on this point see also Balfour M. Mount, The problem of caring for the dying in a general hospital; the palliative care unit as a possible solution, in: CMA Journal 115 (1976), pp. 119–121).

  42. 42.

    Ibid., p. 22.

  43. 43.

    Ibid., p. 66: “Before all else, palliative care must mean excellent symptom control.”

  44. 44.

    Ibid.

  45. 45.

    Balfour M. Mount, Caring in today’s health system (= offprint from CMA Journal 119 (1978)).

  46. 46.

    Ajemian and Mount, R.V.H. manual (1980), pp. 47–60, “Cultural considerations in palliative care”; on this issue see e.g., Margaret Pabst Battin, Ending life. Ethics and the way we die, Oxford: Oxford University Press 2005.

  47. 47.

    For an overview of the developments in the UK, the USA, Australia and New Zealand see Lewis, Medicine (2007), pp. 121–58.

  48. 48.

    Derek Doyle, Palliative medicine in Britain, in: Omega 56 (2007), pp. 77–88.

  49. 49.

    Connor, Development (2007), p. 93.

  50. 50.

    Lampe, Nachricht (1789), p. 10.

  51. 51.

    Karen Nolte, Dying at home: nursing of the critically and terminally ill in private care in Germany around 1900, in: Nursing inquiry 16 (2009), pp. 144–54.

  52. 52.

    Goldblum-Abramowicz, Versorgung (1908), p. 22.

  53. 53.

    Ibid., p. 16.

  54. 54.

    Connor, Development (2007).

  55. 55.

    Stoddard, Hospice movement (1992), pp. 146–80; Siebold, Hospice movement (1992), pp. 97–100; Sylvia A. Lack, First American hospice: Three years of home care, New Haven: Hospice Inc. 1974.

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  1. Institut für Geschichte der Medizin, Universität Würzburg, Würzburg, Germany

    Michael Stolberg

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Stolberg, M. (2017). The Time After 1945. In: A History of Palliative Care, 1500-1970. Philosophy and Medicine, vol 123. Springer, Cham. https://doi.org/10.1007/978-3-319-54178-5_11

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