Yet, Kubler-Ross is not without critics, as many contend that there exists no real evidence that stages are present in coping with death (Stages pp). According to Robert Kastenbaum, using the term "stages" implies that there is a set order of set conditions, and asserts that there is no evidence that dying people go through the exact Kubler-Ross stages in their proper order (Stages pp). He believes that any patient could experience the stages in a different order, or could experience emotions not even mentioned in the Kubler-Ross stages (Stages pp). He explains that in her research Kubler-Ross showed that various patients exhibited qualities from the five different stages, but no one particular patient demonstrated all five stages in order, thus any emotional experience during the dying process of a person could be considered a stage (Stages pp).
Many feel that Kubler-Ross' research needed to be followed up by another form of data gathering, and that had she done this, her theory would be more valid (Stages pp).
Some critics suggested other methods of research, such as behavioral studies and personal diaries kept by patients, might make up for some of the flaws of the interview process, for example, the fact that the information gathered by the interviewer may vary depending on the relationship between the researcher and the patient, and what a patient feels and what a patient reveals in an interview may be two different things (Stages pp). Moreover, many feel that the Stage Theory tends to prescribe rather than describe, and that since the theory has become so popular, it is common for positive value to be place on the attainment of each new stage (Stages pp). Thus, patients may rush themselves or may be pressured by family members to move through the stages on some imaginary schedule (Stages pp). In other words, patients may feel that they must accept their death in order to die properly, simply because that's what the "famous" theory prescribes (Stages pp). Furthermore, the stages of dying can become an easier and more convenient way for patients to deal with their death, rather than doing what comes naturally to them or having to seek answers on their own (Stages pp). Therefore, an individual's entire life may be over-looked in favor of the stages they feel they are supposed to be going through, because as a person nears death, it is easier to focus on the last months or weeks of life rather than to celebrate a person's life as a whole (Stages pp). The unique personality and identity of the person may be lost as they supposedly move through these generic stages (Stages pp). Each individual's experiences are unique and different, thus each person's death process is unique (Stages pp).
However, regardless of her critics, Kubler-Ross' model had an impact on society and motivated people to think about coping with death, and to appreciate that it is important to help understand and care for the needs of those in their final weeks and days (Stages pp). Moreover, many of the problems with the Kubler-Ross model are in society's interpretation and misuse of her research and failure to follow-up her study with more research and data (Stages pp).
Aside from the death of a loved one, there are many circumstances that arise during one's lifetime that may result in loss and grief. In the book, "Many Voices," edited by Doreen Mellor and Anna Haebich, is a compassionate and painful product of Australia's history wars (Rowse pp). The editors brought together a logistically and emotionally challenging research program in response to the Human Rights and Equal Opportunity Commission's 1997 report (Rowse pp). It is also the product of a recently emerged formation within Australian society, an empowered Indigenous middle-class joined with progressive non-Indigenous professionals, dealing with the legacies of colonization strategies known by various terms (Rowse pp). Thousands of Australians experienced sad and angry childhoods and have been left with emotional wounds unhealed (Rowse pp). Embracing assimilation and trained in social science, the authors recalled having witnessed the phasing out of child removals, and that some of these children were neglected and at risk of abuse (Rowse pp). Some officers recall parent's expressions of grief and loss, and no matter whether the removal was short-term or long-term, the pain and suffering caused by the policy was long-term and appears to have been a great burden on the parents and the children (Rowse pp).
Another study by Peter Westoby, published in the May 01, 2003 issue of "Australian Journal of Social Issues," discussed the enormous challenges faced by young people from refugee backgrounds when involved in the settlement process within Australia (Westoby pp). They are forced to locate themselves within a new social cultural geographic and adult space, and also try to find security within the spaces of their own families and ethnic communities (Westoby pp). Wetoby points out that traumas of the past can mix with painful experiences of the present, adding stressors to their lives that are both complex and diverse (Westoby pp). As William James suggested at a psychological level and Agnes Heller at an historical level, it can often be very difficult to neatly separate past, present and future, for although individuals cannot avoid such separations, they know at a deeper level that the past inextricably reaches in the present and future (Westoby pp). Refugees suffer loss of their homes and grief from their experiences, whether fear of persecution or fear of sudden changes that must be faced and accepted before they can move into a comfortable, functioning lifestyle within their new environments (Westoby pp). Thus, much like a death, the past must be dealt with, as well as a coming to terms with acceptance of loss (Westoby pp).
And Robert Ho wrote in the February 02, 1999 issue of "Australian Journal of Social Issues" about the issues associated with euthanasia and the impact on family as associated with the loved one's distress at the loss of dignity and control (Ho pp). Thus, the loved one grieves the loss of a capable body, while the family grieves not only for the loved one's health, but his impending death, and the decision to end it (Ho pp).
Sally N. Ellis Fletcher writes in the September 22, 2002 issue of the "Journal of Cultural Diversity," about the cultural implications in the management of grief and loss (Fletcher pp). According to Fletcher, because people are culturally unique individuals, their culture impact and even dictates their responses to normal events of daily living, such as loss of a loved one, loss of a job, or grief due to separation (Fletcher pp). Fletcher stresses that health care professionals must be culturally sensitive to all individuals, in other words, being aware of the way certain individuals value time, perceive spatial boundaries and communicate with others (Fletcher pp). Thus, culturally diverse nursing care acknowledges the individual's cultural uniqueness and incorporates a variety of approaches to provide culturally sensitive care (Fletcher pp).
Adoption relinquishment involves a grief process not unlike other types of grief such as death or separation (Roles pp). During the initial phase of grief, the birth mother may experience numbness and denial, as she tries to cope with the realization that the birth has become a reality (Roles pp). As the shock and confusion lessen and the denial recedes, then floods of intense feelings may erupt without specific triggering events which can be an overwhelming experience that results in feelings such as sadness, emptiness, anger, fear, panic, despair, shame, guilt, hopelessness and helplessness (Roles pp). Moreover, secrecy, shame and lack of public acknowledgment of the loss by family and friends often results in a lack of validation that the loss actually occurred (Roles pp). The adoption process for the birth mother also results in her living with the unknown, which can be one of the most difficult aspects of this type of loss (Roles pp). Like all processes, resolving birth parent loss and subsequent grief is an individual process (Roles pp).
Christine Porter wrote in the February 01, 2004 issue of "Trial, that representing families in wrongful death cases can be on of the most difficult and yet most rewarding experiences in one's career (Porter pp). Society generally expects people to put a death "behind them" and move on, thus a grieving family's relationship with a law firm may be the last occasion for them to focus deeply on their loved one and the events surrounding the death (Porter pp). According to Porter, often surviving family members are wracked by guilt over seemingly innocuous actions, such as letting their child go on an outing where he or she was killed or did not call a doctor because the spouse insisted they did not need one (Porter pp). In these situations, even responding to a question such as giving a date of birth can strike a powerful emotional chord, therefore, time and patience are the only antidotes (Porter pp).