Palliative medicine was first recognized as a specialist field in the United Kingdom in 1987. One hundred years earlier, the London-based doctor William Munk had published a treatise on ‘easeful death’ that mapped out the principles of practical, spiritual, and medical support at the end of life. In the intervening years a major process of development took place, which led to innovative services, new approaches to the study and relief of pain and other distressing symptoms, a growing interest in ‘holistic’ care for those with advanced disease, and a desire to gain more recognition for end-of-life care. This book traces the history of palliative medicine, from its nineteenth-century origins, to its modern practice around the world today. It takes in the changing meaning of ‘euthanasia’; assesses the role of religious and philanthropic organizations in the creation of homes for the dying; and explores how twentieth-century doctors created a special focus on the care of those for whom cure or recovery is not possible. To Comfort Always traces the rise of clinical studies, academic programmes, and international collaborations to promote palliative care. It examines the continuing need to provide evidence in support of development and assesses the dilemmas of unequal access to services and pain-relieving drugs, as well as the periodic accusations of creeping medicalization within the field. The first history of its kind, it concludes with some reflections on the achievements of palliative medicine to date and the challenges that remain.
HISTORICAL DEVELOPMENT OF PALLIATIVE ESTABLISHMENTS IN THE WORLD AND IN UKRAINE