Authors: Dr Deepali Dhawan , Dr Abbas Ali Khatai

Abstract

Breaking the Bad News !

Any news that drastically and negatively alters the patients view of their future.( Buckmann,1992)

Despite the commitment to openness and right to information, the decision to whether to withhold

or disclose that difficult information continues to trouble the healthcare professionals. Conveying

bad news to the patient themselves or to their attendants is rather a process than an event,

resulting in cognitive, behavioural or emotional deficit, and this lasts beyond the bad news

encounter.

These deficits have implications on how the person will think, behave and feel in their response to

changes, resulting from the news in shorter and the longer term.

For this reason, it is vital for a structured framework to deliver the bad news to be employed that

not only dispense the required information, but also enables them to engage in decision making

about their care when the choices become limited by allowing them to ask questions at the end of

discussion.

Breaking the bad news plays a critical role in patient -physician relationship and a variety of

guidelines have been developed for this purpose, including SPIKES protocol, ABCDE protocol,

BREAKS protocol, PEWTER protocol, SUNBURN protocol and so on.

However, little is known about the physicians’ attitude towards breaking the bad news and the level

of training they have acquired to deliver it.

This paper aims at providing guidance regarding preparation for breaking the bad news, giving

difficult information, responding to the possible reactions and supporting the patients and their

relatives after the bad news has been received by validating a self report questionnaire to assess

the physician attitude towards basic principles of breaking the bad news and training further on.

Keywords: BBN, bad news delivery , SPIKES protocol