Breaking bad news : establishing an auditable procedure for giving the cancer diagnosis

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Abstract

This study aimed to involve patients and health professionals in drawing up a set of auditable guidelines for consultations in which patients are given their initial diagnosis of cancer. It resulted from representations from patients and hospital staff, both of which groups were concerned that the way in which the diagnosis was given was often less than satisfactory, and could prejudice the patient's future emotional well-being. The three stages of the study, data gathering, establishing auditable guidelines and piloting and auditing the guidelines and use of the leaflet, are described. Factors which hampered the study are described, and a number of suggestions about future training of doctors and involvement of trained volunteers are made. The authors conclude that the study demonstrated that problems in communication can be addressed, at least in part, by basic, measurable guidelines which require no special training to carry out. Although designed for use with cancer patients, they are adaptable to any other situation in which bad news has to be broken.

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