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While during the last hours of life most doctors would give enough morphine to keep patients from dying in agony, fears of raising eyebrows among colleagues kept many from giving their dying patients enough medication to be as comfortable as possible for the months they had left to live.Elisabeth Kübler-Ross’s challenged the authoritarian decorum and puritanism of the day.Instead, Elisabeth Kübler-Ross’s groundbreaking work opened up entirely new fields of inquiry into the care and subjective experiences of seriously ill people.
The very act of listening delivered illness and dying from the realm of disease and the restricted province of doctors to the realm of lived experience and the personal domain of individuals.
When I first read as a college student aiming toward a career in medicine, I was struck by the interview transcripts that revealed the respect that was evident in Kübler-Ross’s listening and her unpretentious friendliness toward patients.
The medical culture of the era was highly authoritarian.
A patient’s values, preferences, and priorities carried little weight.
It was also due to the conspiratorial, sunny pretense that doctors, patients, and their families maintained.
Admitting that a person’s pain was getting worse might mean admitting that his or her disease was getting worse.
It was common at the time for doctors to woefully undertreat seriously ill patients’ pain to the (often needlessly) bitter end.
This was only partly due to the fact that doctors were poorly trained in the management of pain and other symptoms.
sparked changes to prevailing assumptions and expectations that transformed clinical practice within very few years.
In reasserting people’s personal sovereignty over illness and dying, Kübler-Ross’s book brought about a radical restructuring of patients’ relationships with their doctors and other clinicians. No longer were dying patients relegated to hospital rooms at the far end of the hall.