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Prim Care. 2001 Jun;28(2):249-67.

Breaking bad news and discussing death.

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Department of Family and Community Medicine, Medical College of Wisconsin, Waukesha Family Practice Residency, Waukesha, Wisconsin, USA.


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.

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