Abstract

KIE: Sample dialogues are presented to illustrate for physicians how to acknowledge their uncertainty concerning the prognosis of terminal cancer patients to family members, how to isolate concerns of the patient, and how to negotiate honest communication between patient and family members who have withheld from each other the truth of the patient's diagnosis. Patients' denial of the seriousness of their illnesses should not be challenged unless it creates significant problems for the patient or relative. Denial, when challenged, must be done gently by pointing out inconsistencies so that defences are not disrupted and yet awareness can be explored.