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10 tips for breaking bad news

1 Before doing anything else, find out what your patient already knows, and what he or she has been told.

1 Before doing anything else, find out what your patient already knows, and what he or she has been told.

2 Then find out what he or she thinks.

3 Then ask what he or she would like to know.

4 And answer honestly – in language that you can be sure your patient can understand.

5 Do as you would be done by – put yourself in your patient's shoes.

6 If the patient seems shocked or surprised, allow time – don't ever try to rush this consultation, whatever the queue in the waiting room.

7 Patient autonomy includes a right not to know – don't be a knowledge bully.

8 Arrange follow-up very soon – there will inevitably be many questions to be answered.

9 Indeed – initial shock may leave the patient too stunned to ask you anything now.

10 Recognise your own needs – breaking bad news is upsetting for the doctor too. Talk to your trainer about how you feel.

Professor David Haslam is president of the RCGP

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Readers' comments (1)

  • I very much liked the advice (7) about not being a knowledge bully
    Also (10) recognising your own needs is well made
    I was disappointed that there was no mention of the importance of the enviroment inn which the news is communicated, the physical setting, privacy, etc
    It is also important that the patient, or sometimes the relative, is given t o be accompanied to hear the news
    The importance of empathising with the patient was not mentioned

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