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  • Introduction
  • 1. Advance Care Planning
  • 2. Communicating Bad News
  • 3. Whole Patient Assessment
  • 4. Pain Management
  • 5. Assisted Suicide Debate
  • 6. Anxiety, Delirium
  • 7. Goals of Care
  • 8. Sudden Illness
  • 9. Medical Futility
  • 10. Common Symptoms
  • 11. Withholding Treatment
  • 12. Last Hours of Living
  • 13. Cultural Issues
  • 14. Religion, Spirituality
  • 15. Legal Issues
  • 16. Social and Psychological
  • More About:

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    Site Index
    Back to Module 2: Communicating Bad News
    A Six Step Protocol

    Step 4. Sharing the Information Step 5. Responding to Feelings

    Step 4: Sharing the Information

    General Guidelines for Breaking Bad News

    • Deliver the information in a sensitive but straightforward manner
    • Say it, then stop
    • Avoid delivering all of the information in a single, steady monologue
    • Use simple language that is easy to understand
    • Avoid technical jargon or euphemisms
    • Pause frequently
    • Check for understanding
    • Use silence and body language as tools to facilitate the discussion.
    • Do not minimize the severity of the situation
    • Well-intentioned efforts to "soften the blow" may lead to vagueness and confusion


    Examples of How to Break Bad News

    You might choose to break bad news by using language like:

    • "Mr Lopez, I feel badly to have to tell you this, but the growth turned out to be cancer."
    • "I’m afraid the news is not good. The biopsy showed that you have colon cancer."
    • "Unfortunately, there’s no question about the test results: it’s cancer."
    • "The report is back, and it’s not as we had hoped. It showed that there is cancer in your colon."
    • "I’m afraid I have bad news. The bone marrow biopsy shows your daughter has leukemia."


    When and How to Say "I'm Sorry"

    • Be aware that the phase "I’m sorry" may be easily misinterpreted...
      • To imply that the physician is responsible for the situation

      • As pity or aloofness
    • If you use the phrase, adjust it to show empathy
    • For example, "I’m sorry to have to tell you this."
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