Breaking Bad News: Why Is It Still So Difficult?

Abstract

A British senior registrar in medical oncology discusses the major difficulties encountered by physicians in disclosing unfavorable diagnoses and prognoses to patients. These difficulties are attributed to an unwarranted assumption by the physician of responsibility for the disease itself; to fears arising from personal reactions to illness, death, and expression of emotions; and to a lack of training in coping with the nonmedical aspects of serious illness. The author suggests that, with only minor changes in the curriculum, instruction in communication can be integrated into orthodox medical education. (KIE abstract)