DISCLOSURE

Any information gained about the patient’s condition belongs to the patient, and must be communicated. The delivery of bad news is very difficult and one can become more skilled at it over time; it is never easy. Arrange to talk to the patient in the company of family, preferably away from other patients. In some cultures, it is not common to give difficult news directly to the patient. We must be aware of the norms and customs of our patients as well as our own culture and the evolving culture of medicine. Navigating the different needs and expectations of these groups can be a challenge at times.

Be clear and direct with what you mean, and what you are saying. Do not say growth or neoplasm if what you mean, and what will be understood, is cancer. Often we try to soften the delivery of bad news by saying too much and confusing the matter, or by saying too little and leaving people with unanswered questions. Be clear, allow people to understand and feel some of the impact of the news and then to ask questions. It is often necessary to repeat the information to other members of the family, or to the same family and patient, the next day.