Breaking Bad News: Can We Get It Right?

Abstract

The health service involves a spectrum of personnel working together towards achieving a common goal, namely the delivery of high quality health care. This involves a large volume of communication between members of staff and patients and their relatives. Doctors are trained to deal with various clinical situations but receive little or no training in communication skills and therefore their communication skills are predominantly instinctive. Patients and their relatives are understandably anxious and vulnerable and it is not surprising that things can go wrong if effective communication is not practiced. Although most doctors communicate effectively, there is increasing evidence that a large number of patients remain unhappy with the amount of information given and the manner of its delivery [1]. Maguire and colleagues found that when doctors use communication skills effectively, both they and their patients benefit [2]. Furthermore, ineffective communication is an important source of complaints and litigations. In a recent Japanese study 81% of litigation involved insufficient or incorrect explanations by the physician [3]. Moreover, in 26% of cases poorly delivered information was found to be the reason that prompted individuals to file a malpractice claim [4]. This article looks into a specific area of communication between doctors, on the one hand, and patients and their relatives on the other; namely “breaking bad news”. It highlights the importance of equipping doctors to effectively communicate with patients and their relatives.