Palliative care history

Such new terms as palliative medicine and palliative care became usual in the medicine world during the 80th.  Palliative (from Latin pallium, cloak) is an area of healthcare that focuses on relieving and preventing the suffering of patients. Thus, it presupposes an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

During the 80th this area became a separate section of clinical medicine. In the meantime, non-governmental organizations were established in many countries with the aim to promote the development of palliative care. Medical and social institutions with the standard set of services sprang up.

The history of palliative care institutions and hospices dates back to ancient times.  The concept of hospice has been evolving since the 11th century. Then, and for centuries thereafter, hospices were places of hospitality for the sick, wounded, or dying, as well as those for travelers and pilgrims.

Mankind has always been taking care about dying, needy and poor. It differed within societies and religion but the idea of mercy didn’t change: to shelter, to nourish, to warm, to mollify, to calm down, to encourage, to support.

Back in Kievan Rus times charity and mercy was considered mandatory for most society members. The princes often gave dinners to the poor, “holy” people were living at their court. There were many cloisters on our territories. Moreover, poorhouses were attached to them, where sick and destitute could find shelter. Monks took care of these people, treating their bodies and souls.

Some shelters and poorhouses have ancient history. For example, one of them was opened in 1342 in the Polish Lublin, in Warsaw the House of the Holy Spirit and the Virgin Mary was established in 1388. But only nowadays the idea of ​​compassion and humanity have a chance to get a standards system, guaranteed by every member of society. This sphere is growing actively, its’ main task is to improve the quality of life and alleviate the suffering of the terminally ill.

In 1967, Cicely Saunders opened the first modern St. Christopher’s Hospice.

In 1969, Elizabeth Kubler-Ross published the first book on thanatology with over 500 interviews with dying patients. The book shocked the community. The issue of legal regulation of patience’s right to deciding the terms of his death was raised in parliaments of many countries.

In 1981, so-called Lisbon Declaration was adopted by the World Health Organization, which included a list of patient rights, in particular the right to die with dignity.

In 1986, WHO accepted “pain scale”.

In 1988, to spread the ideology of Palliative Care European Association for Palliative Care (EAPC) was established. Today, the organization brings together volunteers, people of good will, who aim to develop palliative care, social work, cultural and anthropological issues for terminally ill patients. Nowadays the organization has more than 6,000 permanent members, representatives of many countries and all areas of medicine relating to the care of patients with advanced and terminal cancers and other diseases.

EAPC makes a significant contribution to social development, focusing on information exchange, organization of educational initiatives and conferences, bringing together professionals working in this sphere. Every two years the Association gathers its experts.

The first Palliative Care Congress on European level was held at the University of Milan (Italy), ​​April 23-25, 1988. It became the starting point in the history of the EAPC. Due to the initiative of Professor Vittorio Ventafridda, EAPC was established and comprised of 42 members. This event took place on December 12, 1988.

In 1990, experts’ report “Analgesia in cancer and palliative care” was published, thus palliative care as an independent approach gets official international recognition. Many countries started to set up the first national association and the association of hospice and palliative care: NHPCO and IAHPC (both USA), EAPC (Italy), Help The Hospices ( the UK ).

In 2002, already eight countries developed and established national standards for palliative and hospice care.

In 2003, the Committee of Ministers of the Council of Europe worked out recommendations on palliative care.

Russia was the first country among Commonwealth of Independent States to develop a palliative care. In 1990, Victor Zorza founded the Russian-British Hospice Association and published the book “The Way to the death. Living up to the end”. On the same year Lakhtinski hospice was opened near St. Petersburg.

The first hospices in Ukraine were established in Lviv (chief physician is Eugene  Moskvyak), Ivano-Frankivsk (Head Physician is Lyudmyla-Oksana Andriishyn) Korosten (chief physician is Ludmila Buslaeva). They were opened with the assistance of international organizations.

Hospice in Lviv in particular was founded due to the programme “Ukrainian compassion and care” back in 1989. It became the interest of help service of the Order of Malta, which granted some hospital equipment. The city administration allocated building of the former Children’s Hospital, which was capitally repaired. Methodological foundations of a new medical institution were developed, staffing and funding approved. In March 1997, the Hospice was opened in Lviv.

Now there are about 20 hospices and palliative care units in Ukraine that operate on different principles: national, charitable, community. Of course, not all of them meet international standards of palliative care. But their existence means that patients have the right for pain control, hospice fulfills of their last will and peace to their last way.