A shelter from the abyss: exploring Cicely Saunders’ vision of hospice care through the concept of worldview

Abstract

Over the past two decades, a debate has arisen concerning the history and philosophy of hospice and palliative care. This critical essay extends this debate by linking the analysis of Dame Cicely Saunders’ writings with the concept of worldview, exploring the modern hospice movement vis-à-vis Saunders’ approach to terminal care. Worldviews as cultural classifications of reality provide groups and individuals with meaning to navigate everyday and liminal situations. Using this concept in connection to the discipline of the sociology of knowledge, it is possible to grasp how the origins and principles of modern hospice care, from which current palliative care practices evolved, relate to the sociocultural environment of the postwar era in the West. The analysis focuses on a selected body of Saunders’ writings, mainly written in the 1960s and 1970s, and discusses different components and functions of her revolutionary care paradigm. In this essay, I show that Saunders’ vision of hospice care entails much more than a set of health care practices; it is a complex construct of knowledge and ideas that offers distinct procedures to shelter the dying from pain and loss of meaning. Her vision builds on medical advances and incorporates norms and attitudes related to secularised Protestant and New Age culture, which fostered privatised types of religion and individualistic ideologies and theodicies.