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Arch Med Sci. 2013 Feb 21;9(1):127-31. doi: 10.5114/aoms.2013.33353.

Personal fear of death affects the proper process of breaking bad news.

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Palliative Care Unit, Medical University of Lodz, Poland.



Breaking bad news may be affected not only by insufficient knowledge of a physician, but also by his attitude, religious beliefs, fears, lack of experience, etc. This survey was aimed to test the relation between physicians' fear of own death and philosophy of life and their inclination to break bad news.


One hundred seventy students of the last year of medical faculty filled in a 4-item questionnaire created by the authors. The participants were asked on their opinion on whether to inform patients on upcoming death, as well as fear of their own death and willingness to receive bad news. The last question was aimed to distinguish the respondents based on their determination in philosophy of life.


Ninety-three percent of respondents think that patients should be informed about unfavorable prognosis but only 86% would like to be informed about their own upcoming death. There is a negative correlation between determination of philosophy of life and fear of own death (p = 0.024), but no correlation between fear of own death and the degree of religiousness (Fisher's accurate p = 0.18). Persons determined to receive information on their own upcoming death are more prone to inform patients about their upcoming death (ρ = 0.31; p < 0.0001).


Personal fear of own death and low level of determination of philosophy of life may restrain medical professionals from breaking bad news to patients. Not only knowledge of the principles, but also personal attitude should be addressed in the curriculum of physician-patient communication education.


breaking bad news; education; fear of death

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