Dr Ivan Lichter, ONZ, surgeon, specialist in hospice and palliative care. Died aged 91.

The work of Ivan Lichter helped relieve the suffering and improve the care of thousands of terminally ill patients. He is also credited with changing attitudes to death and dying, so that the hospice movement has become an important part of the medical scene in New Zealand.

In essence Lichter came to dedicate his life to working with patients who traditional medicine could no longer help - a doctor, so it was said, who found he could not turn his back on dying patients.

And it was for his role as the "founding father of palliative care in New Zealand" that in 1997 he was made a member the country's highest award - the Order of New Zealand, an honour restricted to 20 living people. He described the award as a final acknowledgement of his branch of medicine.

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"You can't just treat the illness. You have to treat the whole person - physically, emotionally and spiritually," he said. He was also delighted to see that the holistic treatment he had helped to develop for dying patients was now being applied to those who were not terminal.

Ivan and Heather Lichter and their four children arrived in Dunedin from South Africa in 1961.

Lichter already had considerable medical experience in South Africa (where he grew up) and in Britain as a thoracic surgeon. But in South Africa in their last years he noted the Afrikaans National Party taking control of the country and that even hospital posts were being handed over to their supporters.

There was also the increasing unrest of the native population in response to the harsh apartheid regime and safety was no longer assured. He was determined to leave.

However, going for their first walk in Dunedin, in January, was in Ivan's words "somewhat dismaying".

It was the time of year when "New Zealand moves out of town and departs to their cribs and baches and the streets were deserted. What cars we saw were 20 years old, small and dilapidated".

He was assistant lecturer at the University of Otago, with a joint appointment as surgeon to the Otago Hospital Board, and fitted in easily.

From about 1974 he became actively involved in the care of the terminally ill. He had been impressed by Dr Elisabeth Kubler-Ross' book On Death and Dying and used to give a copy to each new house surgeon arriving at the hospital.

"I saw there was a way of easing the distress of the dying by actively addressing symptom control in conjunction with emotional, social and spiritual relief," he said.

In 1976, his sabbatical leave was almost entirely devoted to visiting hospices overseas and learning how best to provide help for the terminally ill. His hopes of establishing an in-hospital hospice in Dunedin never happened, although he provided hospice-type care on his ward.

Throughout this period he offered consultative advice to the hospital, "a service that was welcomed by some and completely ignored by others".

He retired in 1984 and by invitation of a publisher spent the next two years writing Communication in Cancer Care, his most notable written work of some 50 publications.

In the late 1980s he went to the Te Omanga Hospice in Lower Hutt, which was having difficulties. He stayed for more than seven years, winning the hospice an international reputation, publishing articles and giving papers at international conferences.

In 1993 he moved to renewed retirement in Auckland. Ivan Lichter is survived by his wife Heather, and children David, Jonathan, Barry and Shelley and their families.