Question

Describe the stages in Kübler-Ross’s analysis of dying. Has research supported her stages? Be certain you provide examples for evidence of your answer.

Answer 1

Kübler-Ross’ stages of dying are denial and isolation, anger, bargaining, depression, and acceptance. The first stage denial and isolation is a time when the denying person denies that he or she is really going to die. Next, in the stage of anger, denial is no longer maintained and is turned into anger, resentment, rage, and envy. The bargaining stage, the third stage, is when the dying person develops the hope that death can somehow be postponed. The depression stage, the fourth stage of dying is when the dying person comes to realize the certainty of his or her death. Finally, the stage of acceptance, is when the dying person develops a sense of peace and accepts his or her fate, and sometimes a desire to be alone. Research has not supported her stages according to Robert Kastenbaum. Robert also claims that the stage interpretation neglected the patient’s situations, specific effects of illness, family obligations, and the environment they were interviewed in (Stantrock, 2007).

Zimmermann (2012) se the qualitative method of discourse analysis to examine the use of the term “acceptance” of dying in the palliative care literature from 1970 to 2001. A Medline search was performed by combining the text words “accept or acceptance” with the subject headings “terminal care or palliative care or hospice care”, and restricting the search to English language articles in clinical journals discussing acceptance of death in adults. The 40 articles were coded and analysed using a critical discourse analysis method. This paper focuses on the theme of acceptance as integral to palliative care, which had subthemes of acceptance as a goal of care, personal acceptance of healthcare workers, and acceptance as a facilitator of care. For patients and families, death acceptance is a goal that they can be helped to attain; for palliative care staff, acceptance of dying is a personal quality that is a precondition for effective practice. Acceptance not only facilitates the dying process for the patient and family, but also renders care easier. The analysis investigates the intertextuality of these themes with each other and with previous texts. From a Foucauldian perspective, I suggest that the discourse on acceptance of dying represents a productive power, which disciplines patients through apparent psychological and spiritual gratification, and encourages participation in a certain way to die.