The lack of knowledge of end of life care, noted by the Amercian physician Alfred Worcester in a series of famous lectures, was one factor that contributed to a growing interest in euthanasia in the UK and US.
Shifts in attitude and action
Despite the interest in euthanasia, concerns about improving care at the end of life began to surface in the 1950s. In the UK, attention focused on the medical 'neglect' of the dying, whereas in the US a reaction to the 'medicalisation' of death began to occur.
Four important changes happened. First, there was a shift within professional literature from anecdote to systematic observation. By the early 1960s, leading articles in The Lancet and British Medical Journal were drawing on the evidence of research to suggest ways in which terminal care could be promoted and arguments for euthanasia might be countered.
Second, a new view of dying began to emerge. This helped to refine ideas about the dying process and explore the extent to which patients should, and did, know about their terminal condition.
Third, an active, rather than a passive, approach to the care of the dying was promoted. Proponents were determined to find new and imaginative ways to continue caring up to the end of life - and beyond it, in the care of the bereaved.
Lastly, there was an increasing awareness of the relationship between physical and mental states. This, in turn, gave rise to a more comprehensive concept of suffering which challenged the foundations upon which much of medical practice at the time was set.
More hospice history
Read about other chapters in hospice history including:
