ABSTRACT
This chapter discusses the key issues and skills that are needed to break bad news well. It also has its emphasis firmly in the scenarios typical to palliative care, and respects that the initial diagnosis of a disease may already have been given by another skilled professional. The news may need to be broken to the patient or to the family. Bad news may therefore be broken to the patient and then the family or to the patient and his family at the same time, with the patient’s consent. There will be occasions when a professional may have to consider whether to break bad news over the telephone. Local policies and specific circumstances will inevitably dictate the action taken. There are clinical imperatives that dictate the way in which hospitals and clinics function and many are unavoidable within the context of breaking bad news. Planning is important in all areas of clinical care. When breaking bad news, it is crucial.
