Breaking bad news

Starting with a semi-bad news – the diagnosis of MS – we’ll roleplay through the standard situation of telling and explaining the diagnosis to the patient on the ward.

I am a happy user of the Cambridge-Calgary-Guide for Communication Skills and use the chapter on Breaking Bad News from the book “Skills for Communicating with patients” as a guide, although there is certainly plenty of literature on the subject.

There is one specific point that leaves much room for individual style – namely “Gauge how much the patient wishes to know”. We discuss the most prevalent approaches, including

  • Stepwise: Offer euphemisms of increasing clarity
  • Once and for all: Start with the diagnosis and see what the patient makes of it
  • Introduce the news with a sentence such as “If the diagnosis turns out to be serious how much detail do you want to know?”

There is even a recent article on Bad News in Neurology: Communication and neurology – bad news and how to break them


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