Introduction
Breaking bad news means giving information that will seriously and negatively change a person's view of their present or future, such as a serious diagnosis, a poor prognosis, or a treatment failure. It is one of the most difficult communication tasks in medicine. A structured approach helps the doctor deliver the news honestly and with compassion, and helps the patient absorb it, ask questions and plan. This note covers preparation, a stepwise protocol, emotional reactions, and the doctor's own needs.
Aims
- Give the information honestly, clearly and in a way the patient can understand.
- Respond to the emotions the news produces, without rushing past them.
- Agree next steps and make sure the patient knows where to get help.
Preparation
- Review the facts, the results and the prognosis before the meeting, and be sure of them.
- Arrange a private room, enough time, and, if the patient wishes, a relative or friend present.
- Find out what the patient already knows and how much information they want. Some people prefer to leave the detail to their family.