Elisabeth Kubler-Ross

PHOENIX (AP) - Elisabeth Kubler-Ross, a psychiatrist who revolutionized the way the world looks at terminally ill patients with her book "On Death and Dying" and later as a pioneer for hospice care, has died. She was 78.

She died Tuesday of natural causes at her Scottsdale home, family members said.

Published in 1969, "On Death and Dying" focused on the needs of the dying and offered her theory that they go through five stages of grief - denial, anger, bargaining, depression and acceptance.

"Those who learned to know death, rather than to fear and fight it, become our teachers about life," she once wrote. In another passage, she wrote: "Dying is nothing to fear. It can be the most wonderful experience of your life. It all depends on how you have lived."

Kubler-Ross wrote 12 books after "On Death and Dying," including how to deal with the death of a child and an early study on the AIDS epidemic.

"She brought the taboo notion of death and dying into the public consciousness," said Stephen Connor, vice president of the National Hospice and Palliative Care Organization.

In 1979, she received the Ladies' Home Journal Woman of the Decade Award. In 1999, Time magazine named Kubler-Ross as one of the "100 Most Important Thinkers" of the past century.

Born in Zurich, Switzerland, Kubler-Ross graduated from medical school at the University of Zurich in 1957. She came to New York the following year and was appalled by hospital treatment of dying patients.

"Whoever has seen the horrifying appearance of the postwar European concentration camps would be similarly preoccupied," she said.

She began her work with the terminally ill at the University of Colorado Medical Center in Denver, and was a clinical professor of behavioral medicine and psychiatry at the University of Virginia in Charlottesville.

Kubler-Ross began giving lectures featuring terminally ill patients, who talked about what they were going through. That led to her 1969 book.

"Dying becomes lonely and impersonal because the patient is often taken out of his familiar environment and rushed to an emergency room," she wrote.

"He may cry for rest, peace and dignity, but he will get infusions, transfusions, a heart machine, or tracheostomy. ... He will get a dozen people around the clock, all busily preoccupied with his heart rate, pulse, electrocardiogram or pulmonary functions, his secretions or excretions - but not with him as a human being."

The most important thing Kubler-Ross did was bring death out of the dark for the medical community, said Carol Baldwin, a research associate professor of medicine at the University of Arizona and who worked as a nurse in one of the nation's first hospices in 1979.

"She really set the standards for how to communicate with the dying and their loved ones," Baldwin said recently. "Families learned that it's not a scary thing to watch someone die."

Kubler-Ross is survived her two children, Kenneth Ross and Barbara Lee Ross, and two granddaughters.

In a 2003 Associated Press interview, her son said that his mother, in her final months, was reaping the benefits of the movement she helped start, finding comfort in the constant companionship and dependable care of a group home.

"We get letters and e-mails from around the world," he said. "There's people who say, 'I was going to kill myself' because they've lost children or their husband or wife, and they read her book and it gave them a sense that they should go on."

Copyright © 2004 The Associated Press