ELE­PHANT IN THE ROOM

The Weekend Australian - Travel - - Health -

How doc­tors can give bad news:

Don’t make as­sump­tions based on cul­tural de­mo­graphic in­for­ma­tion; clar­ify in­stead Clar­ify how much de­tail the pa­tient wants Give the pa­tient and fam­ily the op­tion not to dis­cuss, or to dis­cuss later

Ask what the pa­tient al­ready knows or has been told, and clar­ify mis­con­cep­tions

Of­fer to have a sep­a­rate meet­ing with fam­ily mem­bers to dis­cuss their con­cerns

Make eye con­tact (if cul­tur­ally ap­pro­pri­ate), sit close to the pa­tient, use con­fi­dent, warm body lan­guage

Give in­for­ma­tion in small chunks at the per­son’s pace Use clear, sim­ple lan­guage Check to make sure the pa­tient has fully un­der­stood what you’ve just said Lis­ten ac­tively and al­low si­lence Ac­knowl­edge how the pa­tient might feel Be hon­est with­out be­ing blunt Don’t make prom­ises that can’t be de­liv­ered, or that aren’t con­sis­tent with clin­i­cal ev­i­dence

Ex­plain the un­cer­tainty and lim­i­ta­tions of end-of-life in­for­ma­tion

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