[Breaking bad news--a challenge for every physician]

Abstract

Breaking bad news is one of the most important and challenging physician's duties in routine daily work. It is not unusual that such dialogues take place at the very beginning of a doctor-patient relationship and positively or negatively influence the further course. In cases of critically ill patients or in emergency situations clinicians mostly interact with family members who have to cope with their own distress and with uncertainties of their loved one's disease. It is well accepted that good communication can significantly improve coping with the disease and promote patient compliance as well as better fulfilling family needs. Particular difficulties are the often minimal or lacking information on the counterpart and the family network, the expectations of patients and their families and the inability to predict their reactions. It is always a challenge to honestly deliver bad news to a patient and relatives without destroying their hope. Despite often limited time resources a bond of trust should be built up and the patient should be empowered to participate in shared decision making.