The model, which resulted from a qualitative and experiential study, was purposely personal and subjective and should not be interpreted as natural law.

Though the stages are frequently interpreted strictly, with an expectation that patients pass through each in sequence, Kubler-Ross noted that this was not her contention and that individual patients could manifest each stage differently, if at all. Kubler-Ross and others subsequently applied her model to the experience of loss in many contexts, including grief and other significant life changes. She highlighted the importance of listening to and supporting their unique experiences and needs and spurred new perspectives on ways practitioners can support terminally ill patients and their family members in adjusting to the reality of impending death. This led to new approaches to working with patients through the final phase of life. Her work was popular in both the medical and lay cultures and shifted the nature of conversations around death and dying by emphasizing the experience of the dying patient. Some were not even explicitly told about their terminal diagnosis. Dying patients were not always given a voice or choices in their care plan.

Prior to her work, the subject of death was somewhat taboo, often talked around or avoided altogether.

This work is historically significant as it marked a cultural shift in the approach to conversations regarding death and dying. The book explored the experience of dying through interviews with terminally ill patients and outlined the five stages of dying: denial, anger, bargaining, depression, and acceptance (DABDA). Elizabeth Kubler-Ross introduced the most commonly taught model for understanding the psychological reaction to imminent death in her 1969 book, On Death and Dying.

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