Cicely Saunders founded the modern hospice movement. She started as a nurse, was forced out of it by a back injury, and then qualified as a social worker and finally as a physician — by her own account, because nobody would take the argument seriously from a nurse.
Three professions
Saunders was born on June 22, 1918 in Barnet, Hertfordshire. She left Oxford in 1940 to train as a nurse at the Nightingale School at St Thomas' Hospital, and worked through the war.
A back injury invalided her out of nursing in 1944. She went back to Oxford, took a degree in 1945, and qualified in 1947 as an almoner — a hospital medical social worker.
It was in that job that she met David Tasma, a Polish Jewish refugee dying of cancer in a ward with no particular provision for him. They talked over several months about what a place for dying people might be. He left her £500 and the sentence "I'll be a window in your home." There is a window at St Christopher's for him.
Saunders concluded that the change she wanted required medical authority, so at thirty-three she started medical school. She qualified in 1957, at thirty-eight.
Total pain
Working at St Joseph's Hospice in Hackney, she did the research that produced the two ideas the field runs on.
The first was pharmacological and simple: give analgesia on a regular schedule, before the pain returns, in a dose adequate to control it. The practice at the time was to wait until a patient was in pain and asking, and to keep doses low out of a fear of addiction that is meaningless in someone with weeks to live. Saunders demonstrated that regular pre-emptive dosing controlled pain better and needed less drug overall.
The second was total pain — the observation that what a dying patient reports as pain is physical, emotional, social and spiritual at once, and that treating only the physical component leaves most of it in place. A man in pain because he is frightened, or because his family is going to be destitute, is genuinely in pain, and the analgesia will not fix it.
That is a nursing insight, arrived at by someone who had been a nurse and a social worker before she was a doctor, and it is why hospice care is delivered by teams rather than by physicians.
St Christopher's
She opened St Christopher's Hospice in Sydenham, south London, in 1967 — the first purpose-built modern hospice, and built from the start to do three things at once: care for patients, teach, and run research.
The research part is what made it spread rather than remain a good local institution. St Christopher's published, and people came to see it work, among them Florence Wald, the dean of Yale's nursing school, who had heard Saunders lecture at Yale in 1963 and who opened the first American hospice in 1974.
Honours
Saunders was appointed OBE in 1965, made a Dame in 1979, awarded the Templeton Prize in 1981 and the Order of Merit in 1989, and given the Conrad N. Hilton Humanitarian Prize in 2001.
She died on July 14, 2005, aged 87, at St Christopher's, in the hospice she built.
Related
Sources
- Cicely Saunders, for the chronology, the three qualifications and the honours. Accessed September 9, 2026.
- Our history. St Christopher's Hospice. Accessed September 9, 2026.
- Cicely Saunders Institute. King's College London. Accessed September 9, 2026.