End-of-Life Care around the World: Achievements to Date and Challenges Remaining

Abstract

From the moment her interest in terminal care was awakened, Cicely Saunders was alert to the international dimensions of the subject. Her first patient in the late 1940s was an emigré Polish Jew dying alone and in isolation in a busy London hospital. Her letters from the 1950s onwards show an unquenchable thirst for new knowledge and a span of contacts and communications that was global in its reach. By the early 1960s, she was making fact-finding visits to the United States and Europe. Even before it opened to patients, St Christopher's Hospice was a beacon of inspiration to like-minded colleagues from many countries, eager to see how the model of practice was being operationalized and--more important still--how it could be adapted and modified in other settings. In the later years of her life, Cicely Saunders remained in contact with colleagues all over the world. She wrote introductions to numerous textbooks and collections; recorded interviews that were broadcast at international conferences; harnessed her name and energies to major efforts to promote palliative care globally; and, to the very end, served as a source of inspiration to palliative care activists, policy makers, educators, and researchers. As this special issue of the journal demonstrates so eloquently, that legacy lives on.