Dr. Saul Ebema

For one reason or another, the COVID-19 pandemic has made us question whether hospice chaplains are essential or not. There is a sense of moral injury there to a question like that. So, I set out to investigate the role hospice chaplains have played in the history of the hospice movement in the United States.

I did not expect this, but I was pleasantly surprised to see that The Rev. Dr. Edward Dobihal was being credited as one of the founders of the first hospice in the United States- Connecticut Hospice. He was also the first president of the hospice board and a driving force behind the hospice movement in the United States. I then became curious to investigate more about his work in pioneering hospice.

Here is the first piece I wrote about him.

This morning as I was browsing through the website of the National Hospice and Palliative Care Organization (NHPCO). Out of curiosity, I clicked on the tab for Hospice History. There is a list of historical snapshots of great moments in the hospice movement in the United States.

What caught my attention and I think it should catch yours too was the snapshot on the first national hearings on the subject of death with dignity in the U.S Senate in 1972.

The (NHPCO) wrote this.

1972

• Elisabeth Kubler-Ross testifies at the first national hearings on the subject of death with dignity, conducted by the U.S. Senate Special Committee on Aging.[1]

On face value, this statement implies that Dr. Elisabeth Kubler-Ross’ testimony in that hearing played a significant part in the development of hospice in the United States. I agree that Dr. Elisabeth Kubler-Ross was instrumental to the growth of the hospice movement in the United States but not in that hearing.

This is why.

After Dr. Elisabeth Kubler-Ross finished with her testimony. Senator Church who was the chair of those hearings began to interrogate her. Here is how it went.

SENATOR CHURCH: “There is one suggestion here, and I will ask it for the record. I have strong misgivings about this kind of approach, myself, but perhaps you have a different view. Do you think a brick-and-mortar program should be launched to provide entirely any kind of facility for the terminally ill, or should we adapt our hospitals, nursing homes, and other institutions in conjunction with other kinds of care given at those facilities? I think perhaps you have already answered that question, but what about the notion of setting up separate facilities for the terminally ill?”[2]

Dr. ROSS: “I would be very leery if the care of the dying patient would become another subspecialty. I would be opposed if we have some modern death houses which are institutions just for the dying.”[3]

SENATOR CHURCH: “In other words, this would make a bad situation worse, would it not?”[4]

Dr. ROSS: “Yes, there is this danger. It depends, naturally, on the atmosphere of the institution. Basically, St. Christopher’s Hospice in London is a hospital for dying patients exclusively, but the atmosphere there is one of love, care, and acceptance, so it is a beautiful place to be, and I think if I would be dying, I would love to be in a place like this. But this is something we really cannot duplicate in the United States. In England, it does not cost the patient a penny, because of the British system, and they can give them drugs (like heroin) so that they are totally awake and without pain to the very last moment before they die. Those things are not duplicable in this country. I would be much more in favor that we train nurses, physicians, and social workers here who love to work with old and dying patients. Then you will not need special institutions for the care of the dying patient, and the majority would be allowed, at least for the final care, to be at home.”[5]

The following day, Rev. Dr. Edward Dobihal was invited to testify in front of the senate committee. He made a powerful argument for the need for hospice care in the United States. He had spent seven months in England at St. Christopher’s hospice and saw firsthand the importance of hospice care for the terminally ill.

Here is his concluding argument in front of the U.S. Senate.

“Finally, the last point in my presentation is that really providing good terminal care makes a tremendous demand and is very draining on the staff who are providing the care. Here is where I think we have developed a philosophy that is pertinent to the Catholic, pertinent to the Protestant, to the Unitarian, and to the agnostic humanist. We have agreed among ourselves that one of the things that draws us together is a reverence for life.”

He continued.

“It is a concern for our own living and also to support each other as we try to provide this kind of care. In an acute general hospital that kind of support does not exist. It is going to be very important to develop the kind of community that will allow staff people to take strength from themselves and the patients and families they are working with and also to be able to welcome into that community the terminally ill who are in need of its love and care.

For me this is something of a mission. I feel very similar to Dr. Cecily Saunders who in England felt called to this task. I feel that same call. Read the last paragraph where the patient in England told me, “Go back to America and provide places like this, where I have found a place to belong, if you don’t have them in America.”[6]

At the conclusion, Senator Church said.

“That is a good place to end your testimony and the prepared statement will appear in the record. (The prepared statement follows:)”[7]

And then began to interrogate Rev. Dobihal

SENETOR CHURCH: “On the first day of hearings, we heard from Elisabeth Kubler-Ross. She referred to this hospice in England and then she made the comment that sort of thing couldn’t happen in this country. You are trying to make it happen.”[8]

REVEREND DOBIHAL. “Yes. And we disagree on that. I think it can.”[9]

Senator church did not seem pleased with that statement and attempted to call Rev. Dobihal a third-rate psychiatrist because of his theological background compared to Dr. Elisabeth Kubler-Ross who was a psychiatrist

SENATOR CHURCH. “Do you agree with our previous witness, Dr. Krant, that the modern theological student is looked upon by young doctors as a sort of third-rate psychiatrist? Is that in fact what theological schools are turning out these days, third-rate psychiatrists who speak the language of Freud and not the language of God.”[10]

REVEREND DOBIHAL. “I don’t think so. They ought to be intelligent enough to know what the language of Freud is; they ought to be experts in knowing what the word of God is and being able to testify to that.”[11]

He went on to defend his profession like anyone attacked would but also made the strongest case for why hospice care was needed in the United States as the best plan of care for the terminally ill.

So, I think that statement on NHPCO website should instead read:

1972

• The Rev. Dr. Edward Dobihal testifies and makes a strong case for hospice care during the first national hearings on the subject of death with dignity, conducted by the U.S. Senate Special Committee on Aging.

Note: Dr. Elisabeth Kubler-Ross eventually came around and supported the idea of starting hospice care in the United States and played her part in helping Florence Wald, Rev. Dobihal and their team.

Sources

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[1] https://www.nhpco.org/hospice-care-overview/history-of-hospice/

[2] Death with dignity hearings before the special committee on aging United States Senate, 1972

[3] Death with dignity hearings before the special committee on aging United States Senate, 1972

[4] Death with dignity hearings before the special committee on aging United States Senate, 1972

[5] Death with dignity hearings before the special committee on aging United States Senate, 1972

[6] Death with dignity hearings before the special committee on aging United States Senate, 1972

[7] Death with dignity hearings before the special committee on aging United States Senate, 1972

[8] Death with dignity hearings before the special committee on aging United States Senate, 1972

[9] Death with dignity hearings before the special committee on aging United States Senate, 1972

[10] Death with dignity hearings before the special committee on aging United States Senate, 1972

[11] Death with dignity hearings before the special committee on aging United States Senate, 1972