KüBLER-ROSS, ELISABETH 1926-

A Societal Taboo on Discussion of Death

When Swiss-born psychiatrist Dr. Elisabeth Kübler-Ross published her 1969 best-selling book, On Death and Dying, most people in the United States, including those in the medical profession, were reluctant to confront death openly. Kübler-Ross found that medical professionals typically abandoned the dying patient. They dropped in occasionally to see how things were going but spent as little time as possible with the terminally ill. Even for physicians, death was a taboo subject.

The Five Stages of Dying

In her series of conversations with dying patients, Dr. Kübler-Ross identified five main stages through which terminally ill patients pass. The first stage is Denial, the "not me" phase when the patient is unwilling or unable to accept the fact of imminent death. Anger, the "why me?" stage, sets in when symptoms make further denial impossible. The "why now?" stage or Bargaining, is when the patient tries hard to delay the inevitable. He might become an extremely good patient, or donate body parts to science. Then the patient sinks into depression, or Grieving, when he realizes that he must indeed say goodbye to everything and everyone he loves. The final stage is Acceptance, when the patient is ready to let go. While other researchers were unable to repeat her findings and concluded that not all dying patients follow the same progression, almost all investigators found in most cases at least one or two of Dr. Kübler-Ross's stages.

Side Effects

At the beginning Dr. Kübler-Ross's high professional standing helped to focus public and scientific attention on her and her work. Many who attended her seminars and workshops asked her for advice in handling specific problems, and she trained both the medical and lay communities in the art of helping people die. The concept of stages had an enormous impact on health-care providers, especially nurses. Instead of doing little to aid patients in their struggle to come to terms with death, nurses now aim at bringing the patient to the stage of acceptance. The zeal with which some nurses pursue this goal, however, has led to charges that some nurses bully patients to die by the stages.

Growing Skepticism

Much of Dr. Kübler-Ross's later research was directed toward proving the existence of life after death. Her publication To Live Until We Say Goodbye (1979) was both praised as a "celebration of life" and criticized as "prettifying" the real situation. It also included a description of Shanti Nilaya (Home of Peace in Sanskrit), Dr. Kübler-Ross's teaching and healing center in California. She founded this center in the late 1970s as the first of what she hoped would be a worldwide network of similar retreats in which she could expound her theories of survival of the spirit after death in the form of a living entity. Because of the direction that her new research took, she met with growing skepticism from the medical community. However, the public continued to approve of her methods of caring for the dying.