July 14, 2005 marked the death of a woman I consider one of the greatest benefactors of our time. She never became a household name in this country, but Cicely Saunders transformed the way many people around the world are cared for as they die.

I learned about this event belatedly, because American news media have been slow to note Cicely Saunder’s passing.

To my mind, this Englishwoman deserves hall of fame recognition. She was the driving force behind the modern hospice movement that provides the dying with medically enlightened and humanly compassionate support as they approach the end of their life. “We think of her as our patron saint,” says Kristina Snyder, a pioneer who led in founding the first hospice house in Massachusetts.

A decade after having qualified as a physician at age 38, Dr. Saunders in 1967 established St. Christopher’s, the first hospice institution. From this beginning in London, she was the inspiration for the founding of hospice centers and programs in some 95 other countries. In addition, thousands of professionals were to learn hospice care from her.

It undoubtedly helped that, before becoming a physician, Saunders had first been a nurse and a social worker. Seeing the suffering of people from the vantage point of these professions enabled her in time to grasp better than others the meaning of pain and how best to relieve it.

The hospice approach brought skilled medical care together with emotional, social, and spiritual support for those nearing death. The idea was not to attempt to cure people who are obviously dying, but rather to make their last days as comfortable and meaningful as possible.

The United States can now boast of more than 3,000 hospice programs located in virtually every part of the country. Besides the professional staff attached to these programs, an astounding 400,000 people contribute their time as volunteers who help patients and their families.

Not all patients are reached by the hospice movement, however. Fifty percent of all deaths in America take place in hospitals. Unfortunately, many of the patients who die in these institutions do not receive the pain relief they need.

The need to provide this kind of care now seems obvious to many of us, but it took vision and determination for Cicely Saunders to succeed. In England, people have sometimes thought of her as another Florence Nightingale because of her whole-hearted mission to serve the mortally ill. But she was also a medical scientist who did research and published widely the results of her work.

In the first half of her life, Saunders searched for a faith that would fill the vacuum of the agnosticism with which she had grown up. On her graduation from Oxford she found in Christianity a motivation for her life’s work of relieving suffering. She saw the results of her work as a strong refutation of the euthanasia movement that offered a starkly different approach to the end of life.

This creative woman has made it hard to understand why spirituality could ever have been missing from the care of the dying. Similarly, the emotional needs of people in that situation, and that of their family members and friends, have suffered neglect in so much of the medical practice of our era.

Two facts about Cicely Saunders will find a lasting place in my memory. First, she told an interviewer, in recent years, that she would prefer to die from cancer rather than some other cause. This disease, she explained, would give her the time to prepare for death. As it turned out, she got her wish.

Secondly, this courageous woman said there were five statements that people should be prepared to make before they die: “I forgive you. Please forgive me. Thank you. I love you. Good-bye.”

Of course, this beautiful agenda is not accessible to all those approaching death. Many people are denied the opportunity to share these sentiments with those who are close to them.

It also stands, however, as model for living on the part of those whose death is not yet in sight. If you can bring yourself to say these words or, at least, to subscribe to these sentiments, you have surely achieved something important and you might thank Cicely Saunders for the inspiration.

Fortunately, for people in the Boston area, hospice care is widely available. You can find more information about the programs by calling the Hospice & Palliative Care Federation of Massachusetts at (800) 962-2973. End-of-life services can be provided in one’s home, in a hospice facility, or, if necessary, in a hospital. The service teams are one or more physicians, nurses, social workers, home health aides, chaplains, and volunteers.

Hospice seeks neither to hasten death nor to postpone it. The main idea is to make of dying a human experience with freedom from pain and, to the extent possible, anxiety. It is the vision of Cicely Saunders brought to life, and to death also.

Richard Griffin