title: Breaking bad news and discussing death.
abstract: The ability to discuss bad news with a patient and family is one clinical skill that is essential to providing effective end-of-life care. Patients and families value direct, nontechnical explanations that are given by a physician with compassion and kindness. Patients and families also value time to talk, express their feelings and ask questions. The authors review research on delivering bad news, then describe a six step process to guide physicians in discussing bad news with patients: (1) create an appropriate environment; (2) open the meeting; (3) discuss the news; (4) develop a follow-up plan; (5) document the conference; and (6) engage in self-reflection.
authors.affiliation: Department of Family and Community Medicine, Medical College of Wisconsin, Waukesha Family Practice Residency, Waukesha, Wisconsin, USA.
authors.forename: B
authors.initials: B
authors.lastname: Ambuel
authors.forename: M F
authors.initials: MF
authors.lastname: Mazzone
mesh_terms: D000328:Adult; D003142:Communication; D018864:Cultural Diversity; D005190:Family / Q000523:psychology; D005194:Family Practice / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010819:Physician's Role; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000379:methods; D013727:Terminal Care / Q000523:psychology*; D014342:Truth Disclosure