Over the past two decades, a debate has arisen concerning the history and philosophy of hospice and palliative care. This critical essay extends this debate by linking the analysis of Dame Cicely Saunders’ writings with the concept of worldview, exploring the modern hospice movement vis-à-vis Saunders’ approach to terminal care. Worldviews as cultural classifications of reality provide groups and individuals with meaning to navigate everyday and liminal situations. Using this concept in connection to the discipline of the sociology of knowledge, it is possible to grasp how the origins and principles of modern hospice care, from which current palliative care practices evolved, relate to the sociocultural environment of the postwar era in the West. The analysis focuses on a selected body of Saunders’ writings, mainly written in the 1960s and 1970s, and discusses different components and functions of her revolutionary care paradigm. In this essay, I show that Saunders’ vision of hospice care entails much more than a set of health care practices; it is a complex construct of knowledge and ideas that offers distinct procedures to shelter the dying from pain and loss of meaning. Her vision builds on medical advances and incorporates norms and attitudes related to secularised Protestant and New Age culture, which fostered privatised types of religion and individualistic ideologies and theodicies.

Over the last two decades and, most recently because of the COVID-19 pandemic, there has been a growing interest in studying topics related to dying and death in various fields of research. Research has started to explore, in more detail, death and bereavement among nonreligious people in contemporary Western societies. It is now well established that this large social group finds its own meaningful ways to come to terms with grief, loss and finitude. However, these studies typically do not include the perspectives of those living with life-threatening illness and facing death. Drawing on one and a half years of ethnographic research conducted among patients receiving palliative care in Switzerland, this study explores how a nonreligious orientation and other facets of human existence influence emotions and meaning making while dying. This is exemplified by the case of an atheist who I picked from the totality of fieldwork encounters in order to illuminate the nuances and complexities of living with terminal illness. The study found that secular and individualist values make it difficult to find closure and accept death. At the same time, the results show that the identification with the secular features of a worldview can increase well-being by ensuring a sense of permanence in actions and meaning-making habits in dying. Furthermore, this article makes the case for studying attitudes towards dying and death in relation to time and life situation.

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