Zoe Owrutsky, PhD Haymarket Medical Network
Elisabeth Kübler-Ross (1926-2004) was a psychiatrist best known for her pioneering work that transformed our understanding of death, dying, and grief. In her ground-breaking book On Death and Dying (1969), she introduced the “five stages of grief” (also known as the Kübler-Ross model), which has since become a cornerstone in psychology, palliative care, and bereavement counseling.1 Her advocacy for patients who are terminally ill and for more compassionate end-of-life care shaped modern hospice and palliative medicine, leaving an enduring legacy.
Kübler-Ross’s career was marked by an unwavering commitment to treating dying patients with dignity and respect at a time when the medical community largely avoided discussions about death.2-4 Despite this, she fearlessly confronted the subject, challenging physicians, caregivers, and society at large to address the emotional and psychological needs of terminally ill individuals. Her work laid the foundation for substantial reforms in palliative care, inspiring future generations of doctors, nurses, and other practitioners to treat death as a natural part of life rather than a medical failure.
Early Life and Education
Kübler was born to a middle-class family on July 8, 1926, in Zürich, Switzerland, as one of a set of triplets.3 From a young age, she demonstrated a strong desire to help others and forge her own path. At 5 years old, she was hospitalized with pneumonia and witnessed the peaceful passing of her hospital roommate — an event that profoundly shaped her understanding of death.4 Another pivotal moment in her early childhood occurred when she saw a neighbor who had experienced a fatal injury spend his final moments trying to reassure and comfort his family despite his suffering.4 These early encounters left an impression that later shaped her belief that death was not something to be feared but rather a topic that should be approached with dignity, acceptance, and understanding.
Women’s history in medicine
The outbreak of World War II during Kübler’s adolescence also deeply impacted her worldview. She felt a strong sense of responsibility to help those in need, which led her to volunteer to help victims of the war. She first worked as a laboratory assistant in a hospital for refugees. In 1945, she became an activist with the International Voluntary Service for Peace.4 Her humanitarian efforts took her to France, Poland, and Italy, where she helped rebuild communities that had been ravaged by war. During this time, she visited the Majdanek concentration camp in Poland and encountered a young girl who had managed to escape death at the gas chambers.4 According to Kübler, instead of harboring resentment, the girl had chosen to embrace love and compassion, saying, “If I can change one person’s life from hatred and revenge to love and compassion, then I deserved to survive.”4 These experiences inspired Kübler’s lifelong mission to heal others.
Throughout her early life, Kübler’s humanitarian work and exposure to suffering solidified her desire to become a physician. However, her father opposed her ambitions.4 Undeterred, Kübler left home at age 16 and worked various jobs to support herself while pursuing her education. In 1951, she enrolled in medical school at the University of Zürich.4 She graduated in 1957.
In 1958, Kübler married Emanuel Robert Ross, an American physician she met during medical school, and they moved to the United States.3,4 Both completed internships at the Glen Cove Community Hospital in New York before Kübler-Ross pursued a residency in psychiatry at Manhattan State Hospital, followed by a fellowship at Montefiore Hospital in the Bronx.4
After the birth of their first child in 1962, the couple moved to Denver, where Kübler-Ross took a position at the University of Colorado School of Medicine.4 In 1965, after the birth of their second child, the family relocated to Chicago, where Kübler-Ross became Assistant Professor of Psychiatry at Billings Hospital at the University of Chicago. There she began hosting seminars on death and dying, which shaped what would become her most influential work.4,5
Medical Career
Kübler-Ross’s work transformed the medical community’s approach to dying patients, shedding light on the neglect and isolation they often faced in hospitals. Before her influence, death was rarely discussed openly in medical settings, and physicians avoided addressing terminally ill patients’ emotional needs.4,5 Her 1969 book On Death and Dying challenged these norms by introducing her model on the five stages of grief — denial, anger, bargaining, depression, and acceptance.6 The book influenced medical practice and also led to increased public demand for more compassionate end-of-life care.5
Throughout her career at Billings Hospital, Kübler-Ross conducted extensive seminars that included interviews with patients who were dying. Rather than seeing terminally ill patients as cases to be managed until their deaths, she believed in engaging with them until the very end, listening to their fears, and allowing them to express their emotions. During her seminars, she allowed terminally ill patients to speak openly with doctors and medical students about their experiences with dying.5 These were foundational in developing the five stages of grief model. Kübler-Ross emphasized that open communication between patients and health care providers was essential in fostering dignity at the end of life. She also advocated for increased pain management and psychological support for terminally ill patients, which helped influence medical protocols in palliative care.
Despite her impact, Kübler-Ross faced opposition. Many in the medical community dismissed her theories, arguing that the five-stage model oversimplified the grieving process.7 Critics also resisted her push for more holistic care, as the prevailing dogma often prioritized curative treatments over emotional well-being. Nevertheless, her advocacy spurred substantial reforms, contributing to the establishment of hospice programs worldwide.
One of her most lasting contributions was helping to establish the field of narrative medicine, which focuses on the importance of patient storytelling in understanding their experiences.5 Through her lectures and workshops, Kübler-Ross trained physicians to actively listen to patient’s life stories, emphasizing that acknowledging a patient’s journey was just as important as treating their illness. By challenging social and medical taboos about death, Kübler-Ross influenced the broader field of palliative care, ensuring that psychological and emotional support became integral aspects of patient care. Her work not only advanced medical knowledge but also led to changes in hospital practices, enabling dying patients to receive the dignity, pain relief, and emotional support they deserve.4,5
Social Impact and Legacy
Kübler-Ross’s influence wasn’t limited to academia. She became a vocal advocate for the hospice movement, which seeks to provide compassionate, patient-centered care for people who are terminally ill. Her teachings emphasized the importance of holistic care, recognizing that the emotional, psychological, and spiritual needs of dying patients were as important as their physical care.
In the 1970s, Kübler-Ross helped establish some of the first hospice programs in the United States, inspired by the work of Dame Cicely Saunders, who had founded the modern hospice movement in the United Kingdom a few years earlier.1
In her later years, Kübler-Ross dedicated much of her time to advocating for children facing terminal illness and addressing the unique emotional and psychological challenges faced by dying children and their families.4,5 In her books such as On Children and Death and in her practice as a physician, she offered guidance on how to provide compassionate support to young patients and their caregivers, ensuring that children could face the end of life with dignity and care.8
Kübler-Ross also worked extensively with patients with AIDS during the height of the epidemic, advocating for compassionate care during a time of widespread stigma and discrimination.5 She focused on providing humane and supportive care to people with the disease, including those who were incarcerated. She considered this work among her most meaningful contributions, striving to ensure that people affected by AIDs received proper medical and emotional support.5
Kübler-Ross was recognized with numerous awards and honors throughout her career. She received more than 20 honorary degrees and was named one of Time Magazine’s “100 Most Important Thinkers” of the 20th century.3 She died in 2004 at age 78. In 2007, she was posthumously inducted into the National Women’s Hall of Fame in recognition of her contributions to medicine and society.3
References:
- Elisabeth Kübler-Ross Biography. Elisabeth Kübler-Ross Foundation. Accessed March 3, 2025. https://www.ekrfoundation.org/elisabeth-kubler-ross/
- What the Elisabeth Kübler-Ross Archive means to the Department of Medicine. Stanford Medicine Department of Medicine News. Accessed March 3, 2025. https://medicine.stanford.edu/news/current-news/standard-news/Kubler-Ross-Archive.html
- Elisabeth Kübler-Ross. Women of the Hall. National Women’s Hall of Fame. Accessed March 3, 2025. https://www.womenofthehall.org/inductee/elisabeth-kblerross/
- Dr. Elisabeth Kübler-Ross. Changing the Face of Medicine. US National Library of Medicine. Accessed March 3, 2025. https://cfmedicine.nlm.nih.gov/physicians/biography_189.html
- Newman L. Elisabeth Kübler-Ross. BMJ. 2004;329(7466):627.
- Kübler-Ross E. On Death and Dying. Macmillan; 1969.
- Tyrrell P, Harberger S, Schoo C, Siddiqui W. Kubler-Ross stages of dying and subsequent models of grief. StatPearls. Updated February 26, 2023. Accessed March 11, 2025. https://www.ncbi.nlm.nih.gov/books/NBK507885/
- Kübler-Ross E. On Children and Death. Collier Books; 1985.
