欧洲第一家临终关怀医院?“Hundertsuppen”——纽伦堡医院(1770-1813)。

Michael Stolberg
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摘要

到目前为止,临终关怀院一直被认为是19世纪末的“发明”。基于对入院日志和其他档案资料的分析,本文将纽伦堡的“Hundertsuppe”医院作为一个在100年前就已经展示出现代临终关怀最特征的机构。它成立于1770年,最初是一家慢性病医院,几乎从一开始就主要是为身患绝症的贫穷病人提供服务,这些病人可以在相对舒适的环境中度过生命的最后几个月、几周或几天,得到护理、精神和医疗照顾。这一主要功能得到了医院负责人的明确认可。近70%的极高死亡率证明了这一点,近三分之二的患者住院时间不到3个月,“消费”是死亡的首要原因。最后,将"百底病"作为死亡机构的一个典型案例加以讨论,这是由于新的"治疗"医院对不治之症和垂死病人的护理不足而产生的;19世纪晚期的第一家英国临终关怀医院和20世纪60年代颇具影响力的圣克里斯托弗临终关怀医院(通常被认为是由霍华德·巴雷特和西塞莉·桑德斯等富有魅力的个人创始人创立的)源于类似的背景。
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[The first hospice for the dying in Europe? The 'Hundertsuppen'--hospital in Nuremberg 1770-1813].

Hospices for terminally ill and dying patients have so far been considered an 'invention' of the late 19th century. Based on the analysis of admission journals and other archival sources, this paper presents the hospital 'Hundertsuppe' in Nuremberg as an institution which already exhibited most characteristics of a modern hospice 100 years before that. Established, in 1770, as a hospital for chronic diseases, it served almost from the start primarily as an institution for fatally ill, poor patients, who could spend the last months, weeks or days of their life in relative comfort, with nursing and spiritual and medical care. This primary function was explicitly accepted by those in charge of the hospital. It is evidenced by an extraordinarily high mortality of almost 70%, with almost two-thirds of the patients staying for less than 3 months and 'consumption' being the foremost cause of death. In conclusion, the 'Hundertsuppe' is discussed as an exemplary case of an institution for the dying which arose due to the insufficient care for incurable and dying patients in the new 'curative' hospitals; the first English hospices in the late 19th century and the influential St. Christopher's Hospice in the 1960s, commonly attributed to charismatic individual founding figures like Howard Barrett and Cicely Saunders, are shown to have originated from similar contexts.

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