Delivering Bad News to Death-Sick Patients

One of the most difficult tasks in a doctor’s work is telling bad news to patients. This is difficult both for patients and doctors. This problem is very complex, and considering it requires careful attention to various factors. According to Ashley and O’Rourke, in the past, some doctors thought that the less the patient knew about his condition, the better his or her chances would be for recovery (2002, p. 187). It depends on the patient how this information will be accepted; some people may accept their destiny, while others may be heavily influenced, and this influence can affect their health and condition. No less important is how a doctor can explain this information, to do it in the right way; a doctor has to approach this carefully to not harm the patient.

Doctors who work with cancer patients often have to tell bad news several times a month, or even in a week. These doctors have great mental pressure, as it is very difficult to be compassionate to every patient. Eventually, this job becomes routine, and the doctor has to have a strong psyche to hang in there and not lose humanity.

A positive effect, which is called placebo, depends on what the patient knows about his or her disease. This effect is based on the autosuggestion of the patient; if a patient truly believes in being cured, it may increase the chances that he or she will be cured even if the disease is bad. Experiments show that the healing process depends on the faith of the patients, and telling the truth may have negative consequences. Positive placebo responses are likely if patients have positive expectations about treatment (Shapiro, 2010, p. 226).

However, patients have a right to know about their physical state, as they will get to know about it sooner or later, so there is no need to hide the truth. Doctors in many countries are also obliged to tell the truth to patients, otherwise they are breaking the law. A doctor’s career depends on telling the truth to the patient, and he or she has no choice, and even if lying is better to the patient, the doctor has no legal right to hide the truth.

No one knows a person better than relatives. In most cases it is recommended to consult with relatives before telling a painful truth to a patient. Relatives can help to find the best approach of telling bad news to a patient, or they can insist on not telling anything about the disease. The problem is that people are different, every person has their own perception of bad information and it cannot be predicted whether this reaction will affect a patient’s condition in a positive or negative way. Ashley and O’Rourke think that patients should be given an accurate assessment of their condition (2002, p. 186).

There are a few cases when death-sick patients are cured without any obvious reasons. Telling the truth to such patients can cause negative consequences. Even if such a person is cured, the nervous system can be irreversibly damaged by telling bad news. However, it is impossible to know whether a patient will be cured or not, as these cases are exceptions.

Considering all the facts, there is no universal answer for this difficult question. A famous proverb says, “the bitter truth is better than a sweet lie,” but sometimes truth is so bitter that no one can take it. Sooner or later patients will understand everything without any diagnosis, and in some cases, patients know everything about their own state. I think that there are more pros for telling the truth, as a fatal diagnosis will be revealed sooner or later. If society wants to change the order of things, first of all, society has to convince the government in adopting appropriate laws.


Ashley, B. M., & O’Rourke, K. D. (2002). Ethics of health care: An introductory textbook. Georgetown University Press.
Grob, G. N. (2002). The deadly truth: A history of disease in America. Harvard University Press.
Shapiro, A. K., & Shapiro, E. (2010). The powerful placebo: From ancient priest to modern physician. Johns Hopkins University Press.

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