Abstract
There is no painless way of breaking bad news. However, providing patients and their relatives with information which may be very distressing to them is an important contribution to their coming to terms with a tragedy. Clinicians often seek to avoid being the bearers of ill-tidings, not through malice or a lack of concern but, particularly, through their anxiety about being able to deal with the consequences of giving such information and a natural reluctance to avoid causing distress to others. While confirmatory research data are sparse, clinical experience suggests a number of guidelines for breaking bad news. These always have to be used flexibly and tailored to meet the specific needs and circumstances of those who are to be told.
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