A man regarded as one of the founding fathers of palliative care and the modern hospice movement in New Zealand has died at his Auckland home.

South African-born Dr Ivan Lichter, who was appointed in 1997 to the Order of New Zealand, the country's highest honour and restricted to 20 members, was 91.

The thoracic surgeon devoted his life to palliative care, improving the standards of care for terminally ill patients and changing attitudes to death and dying.

His work in developing palliative care in New Zealand is reflected by the general acceptance of the hospice philosophy and in the practice of holistic care, which is now offered to patients suffering any form of distress.

Dr Lichter began to apply the principles of palliative care when he was a thoracic surgeon at Dunedin Hospital and when he was an associate professor in surgery at the University of Otago Medical School in the early 1970s, as it was during these times he recognised the inadequacy of care for the terminally ill.

In view of his experience in working with often terminally ill patients, he came out of retirement to become the medical director of the Te Omanga Hospice in Lower Hutt and remained in that position until 1993.

Dr Lichter also devoted himself to teaching palliative care to yearly intakes of medical student interns and hospital medical registrars on a one-to-one basis in a clinical setting, thus influencing the interactions medical students had with their patients.

Dr Lichter wrote more than 50 publications, including more than 25 on aspects of palliative care.

His most notable written work was Communication in Cancer Care, written in 1987, explaining the illness of cancer patients. The book promotes family support for the patient and encourages the understanding of the emotions attached to the sickness.

Dr Lichter was educated at Grey High School, Port Elizabeth, South Africa, and studied at the University of Witwatersrand Medical School in Johannesburg.

During World War 2 he served in the South African Medical Corps, and came to New Zealand with his family in 1961.

Dr Lichter, who died on Friday, is survived by his wife Heather, sons David, Jonathan and Barry and daughter Shelley, and eight grandchildren.