Do You Avoid Giving Bad News to Patients?

September 06, 2017

Physicians don't like delivering bad news to their patients any more than their patients like receiving it, studies suggest.

For example, French researchers, publishing in the Journal of Clinical Oncology, reported on a meta-analysis of 40 investigations that focused on the experiences and points of view of 600 oncologists from 12 countries when they had to break bad news to their patients.

After considering many different factors, including individual relationships with the patient, the patient's family, the office environment, and cultural differences, the analysis found that the majority of oncologists considered delivering unwelcome information to be emotionally difficult and unpleasant. They described both physiologic reactions, such as heightened autonomic arousal, and emotional reactions, such as anxiety, anger, exhaustion, guilt, a feeling of failure, and frustration. Factors such as lack of time, limited privacy, and communication challenges tended to make matters worse.

A story that illustrates that point involves a doctor who held off telling a patient about her advanced lung cancer diagnosis so she could enjoy a 2-week cruise. The patient contracted pneumonia and died while on vacation. Far from being grateful, her family was very upset, perceiving his actions as paternalistic rather than compassionate.

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