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InnovAiT 2009 2(10):605-612; doi:10.1093/innovait/inp133
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© The Author 2009. Published by Oxford University Press on behalf of the RCGP. All rights reserved. For permissions please e-mail: journals.permissions@oxfordjournals.org

Breaking bad news—skills and evidence

Professor Jill Thistlethwaite

Institute of Clinical Education, Warwick Medical School, University of Warwick, Coventry

E-mail: j.e.thistlethwaite{at}warwick.ac.uk


  Abstract

Bad or unfavorable news may be defined as ‘any news that drastically and negatively alters the patient's view of her or his future’ (Buckman 1992). When GPs talk about breaking bad news, they usually mean telling patients that they have cancer, though in fact similar communication skills may be employed when informing patients about a positive human immunodeficiency virus status, or that a relative has died. Of key importance in the process is the doctor gaining an understanding of what the patient's view of the future is or was—the expectation that now might not be met. A doctor should not assume the impact of the diagnosis without exploring the patient's worldview.


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