Doctors in denial about death, their own powerlessnessMedical students were invited to attend the seminars, but for a long time, none did. “The physicians have been the most reluctant in joining us in this work,” Kübler-Ross noted in On Death and Dying. “It may take both courage and humility to sit in a seminar which is attended not only by the nurses, students, and social workers with whom they usually work, but in which they are also exposed to the possibility of hearing a frank opinion about the role they play in the reality or fantasy of their patients.” American doctors were so preoccupied with avoiding death that they avoided any discussion of it. “I observed the desperate need of the hospital staff to deny the existence of terminally ill patients on their ward.” This was typical for the medical profession at the time. In the early 1970s, years after Kübler-Ross began her research, only about 10 percent of doctors told their patients when they had a terminal condition; until 1980, the American Medical Association considered it a doctor’s right not to tell their patients if they had an incurable disease. At Kübler-Ross’s hospital, most doctors would inform the patient’s family of a fatal diagnosis and allow them to decide what to share with the patient.