Breaking bad news is an important task for physicians, as it enables patients and family members to choose their preferred medical care. It also improves patients’ sense of control.
But there is reluctance among medical professionals to give bad news, probably because:
• bad news may abruptly disorganize the patient psychologically, and
• professionals experience difficulties conveying this kind of information.
Some physicians affirm that breaking bad news is an innate skill that cannot be acquired. This is incorrect.
Studies of physician education demonstrate that communication skills can be learned (with structured training) and have effects that persist long after the training is finished.
A step-wise approach is the best way to test the pace at which the individual wishes to know what is happening.
Robert Buckman has outlined a six-step protocol for breaking bad news.
1) Getting started.
2) Finding out how much the patient knows.
3) Finding out how much the patient wants to know.
4) Sharing the information.
5) Responding to the patient’s feelings.
6) Planning and follow-through.
See reference for more information.
Adapted from Back T. Breaking bad news. Ethics in Medicine. University of Washington School of Medicine. Internet. Available at https://depts.washington.edu/bhdept/ethics-medicine/bioethics-topics/detail/55. Accessed on February 15, 2020.