The modern hospice movement, which became a formalized Medicare benefit in the United States in 1983, shifted the focus of end-of-life care from curative treatment to palliative comfort, emphasizing patient autonomy and dignity. The movement began with Dame Cicely Saunders, a British nurse and social worker who founded London’s St. Christopher’s Hospice in 1967. Saunders’s primary innovation was a holistic approach to care for the dying, in which the management of physical pain was seen as inseparable from the patient’s emotional and spiritual needs. This philosophy provides the framework for the central conflict in Some Bright Nowhere. When Claire decides to stop treatment, she exercises her right to choose the terms of her final months, seeking what Saunders called “a sense of fulfillment and a readiness to let go” (Roberts, Nicole. “The History of Hospice: A Different Kind of Health ‘Care’.” Forbes, 22 Jun. 2018). Her specific request, however, that her husband Eliot leave and allow her female friends to be her primary caregivers, reflects contemporary, gendered social dynamics in caregiving, in which women frequently provide more hands-on emotional and personal care, while men may focus on practical tasks and management.