ABSTRACT
More than 40 years ago, John Hinton conducted a study at King’s College Hospital in London, which examined – for the first time ever in a structured way – the physical and mental distress of patients dying on the medical ward of an acute hospital. Most of the patients had cancer, but there was also a group of 14 who were dying of heart or renal failure. This study1 proved a major stimulus to the development of ‘terminal care’, as it was then known, and to the growth of the hospice movement in Great Britain. Terminal care in the UK grew up in most places as a voluntary provision, centred around an inpatient facility, which, if it existed at all, was usually precariously maintained by charitable funding. Many of the charities that supported hospices or home care for the dying were specifically cancer charities, and as a result many hospices restricted their services to the care of patients dying of cancer. To a considerable extent, this tradition still influences the provision of palliative services in the UK.
