Psychological medicine

Giving bad news

John Buchanan



The patient’s illness experience has physical and emotional elements, and the management of issues in each area is part of the responsibility of medical carers.

Article Extract

  • In the community, widespread fears of illness and dying inhibit communication. Elements of these include: lack of close experience of death in the modern community; high expectations of health; fears about severe symptoms of physical illness and about treatment; and fears about psychological breakdown and ‘going crazy’.
  • In some cultures there is a belief that to tell someone of a terminal illness will cause them to ‘go crazy’. Some families, therefore, may be vigorously opposed to ‘telling’ interviews, and there may be a need to deal (gently) with the denial of the family first.