title: A synthesis of the literature on breaking bad news or truth telling: potential for research in India.
abstract: The high incidence of fatal diseases, inequitable access to health care, and socioeconomic disparities in India generate plentiful clinical bad news including diagnosis of a life-limiting disease, poor prognosis, treatment failure, and impending death. These contexts compel health care professionals to become the messengers of bad news to patients and their families. In global literature on breaking bad news, there is very little about such complex clinical interactions occurring in India or guiding health care providers to do it well. The purpose of this article is to identify the issues for future research that would contribute to the volume, comprehensiveness, and quality of empirical literature on breaking bad news in clinical settings across India. Towards this end, we have synthesized the studies done across the globe on breaking bad news, under four themes: (a) deciding the amount of bad news to deliver; (b) attending to cultural and ethical issues; (c) managing psychological distress; and (d) producing competent messengers of bad news. We believe that robust research is inevitable to build an indigenous knowledge base, enhance communicative competence among health care professionals, and thereby to improve the quality of clinical interactions in India.
authors.affiliation: Social Aetiology of Mental Illness - CIHR Postdoctoral Fellow, Centre for Addiction and Mental Health, 455 Spadina Avenue, Toronto, Ontario, M5S 2G8, Canada.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Martis
authors.forename: Anne
authors.initials: A
authors.lastname: Westhues
keywords: Breaking bad news; Clinical communication; Life-limiting disease; Patient care in India; Truth telling