Breaking bad news to the patient: Dilemma for Doctors

The biggest dilemma for doctors is to tell the family members that their patient is no more.

Delivering bad news to the families is a very challenging task for many doctors.

There have been multiple times when doctors have felt uncomfortable and often miserable at times of discussing the deteriorating patient’s health. The news could be confirmation of a major illness, unexpected lab reports, recurrence of a disease and even a terminal prognosis. All these need to be shared with the patient no matter how difficult it may seem to communicate. But it should be done and the most effective and compassionate way possible that doesn't need to confusion or additional suffering for the patient.

A recent post by Vincent Mor, PhD and health service researcher from Brown University, Providence, RI highlights that physicians are often reluctant to have a conversation about advance care planning. If the patient is handled well before the tests take place, he'll be able to absorb the news and adverse test results in a more positive way. Delivering the bad news to the patient often results in shock and grief from the patient's side. The family members or the patient may turn rebellious as it is totally unexpected for him.

Some measures that the practitioners can take to make the process easy for the patient as well as themselves are:

  Tell the truth as it is: No matter how bad the situation is, the patient has the right to know what is wrong with his body, and there is no fabrication needed for it. Tell all the aspects of the test findings and what impact can it have on the body. Discuss all the possible treatment options and let the patient decide and get comfortable with it.

  Give some time to the patient: Just when the bad news is hit, a long silence may follow. Do not ask inappropriate questions like ‘How are you feeling’ or ‘Do you have any questions’. You as a doctor already know how he or she must be feeling and it is too early for the patient to be asking questions

 Be well prepared before the meeting: Ask the patient if it is the right time to discuss important information with him. You can include more family members at the time of sharing the news. Ask the patient what they understood and remain your calm at all times.