Palliative Care

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What is a hospice?

Hospice care focuses on the palliation of a terminally ill or seriously ill patient’s pain and symptoms, and attending to their emotional and physical needs. Many of the central principles by which modern hospices operate were pioneered in the 1950s and 1960s by Dame Cicely Saunders.

Hospices in the UK

The UK hospice movement has grown considerably since Dame Saunders opened St Christopher’s hospice in 1967. In 2011 Help The Hospices (the leading charity supporting hospice care in the UK) said there were 220 inpatient units for adults, 42 units for children and 272 day care services across the UK.[1] Hospice care can run for days, months or years. Most care is provided in people’s own homes, but people also visit hospices for day therapy and stay as inpatients. Funding varies from 100% backing by the NHS to almost 100% backing by charities. The service is always free to patients. Britain is the only country in the world where palliative care is a recognised medical specialism with a full four-year training programme.[2] In a recent survey by The Economist Britain was ranked first in the world for quality end-of-life care. The survey took in 40 OECD and non-OECD countries, including the USA, the Netherlands, Germany and France.[3]

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Help the Hospices position on end of life issues

Help the Hospices is the principal charity in the UK offering services to support hospices. They also champion the cause of hospice care in Westminster and in the media and offer education and training courses for professionals working in hospice care. The website home page says “You Don’t Come Here to Die. You Come Here To Live.”[4] In regard to assisted suicide and euthanasia Help the Hospices assert: “across society there is a range of different views, and we respect the right of everyone to take an individual position. It is our view that the question of whether there should be a change in the law is one for society to consider and for the parliaments and assemblies across the UK to decide.” Furthermore they maintain: “Help the Hospices is not aware of any hospice that currently supports a change in the law to legalise assisted dying in any form, or any that considers that a change in the law would be in the best interests of the people they care for. However, the views of many staff and volunteers working in hospice care reflect the diversity of opinion within wider society.”[5] The late Dame Cicely Saunders repeatedly spoke of her opposition to any change in the law. She once said “You matter because you are you, and you matter to the last moment of your life. We will do all we can not only to help you die peacefully, but also to live until you die.”[6]

Perinatal Hospice Care

Perinatal hospice care is a way of caring for families whose babies' lives are expected to be brief. It can easily be incorporated into ordinary pregnancy and birth care just about anywhere. Support begins at the time of diagnosis, not just after the baby is born. During The Parliamentary Inquiry into Abortion on the Grounds of Disability in 2013 Amy Kuebelbeck of the US organization,, described perinatal hospice as an approach that “walks with these families on their journey through pregnancy, birth, and death, honouring the baby as well as the baby’s family. The concept builds upon the pioneering work of Britain’s own Dame Cicely Saunders, founder of the modern hospice movement. Perinatal hospice is not a place; it is more a frame of mind. It is a way of caring for the pregnant mother, the baby, the father, and all involved with dignity and love.”[7]

With such care, the baby can be treated with dignity, loved and protected until death comes naturally. While the life expectancy of these babies is brief, they do have a life and are significant family members who will be valued, remembered and treasured. Palliative and hospice care can show that the reminder of life is still worth living. Research conducted by Calhoun and Hoeldtke shows that parental responses to perinatal hospice are “overwhelmingly positive”.[8] According to Dr Hilary Cass more paediatric palliative care consultants are needed in the UK as there are only 10 specialists at the moment. Further, there should be more awareness of the possibility of a referral for this type of service.[9]  







[7] Parliamentary Inquiry into Abortion on the Grounds of Disability. July 2013. P25

[8] Calhoun & Hoeldtke 2000

[9] Ibid p26