HOW TO DELIVER "BAD NEWS"
Awareness and sensitivity to the emotional state of families coping
with children suffering from developmental disabilities or chronic
illness should begin even before the family receives the news of the
child's condition. The specific diagnosis is in of itself harsh and
becomes more intolerable because of the discrepancy between the
diagnosis and the parents' hopes and expectations. However, the
timing and manner in which the diagnosis is communicated can be
very significant to the lifelong journey ahead. In our role as physicians,
we must remember that information is meaningful and effective when
transmitted in a personal and timely manner, comprehensively and
specifically to the child. Parents should be prepared, we must ensure
that they are ready to listen and have the emotional resources to face
the news. When professionals are conversant with a family's "journey"
they are better able to respond appropriately. Socrates deliberated
how physicians can assimilate the knowledge and the capacity to
cope with the tough situation of delivering bad news. "Can these
principles be taught or are they acquired?" he asked. Indeed,
physicians learn this skill through their own acquired experience and
via mentors. These principles must be assimilated through the course
of medical training and by all physicians. An approach based on the
family's and child's strengths and which encourages parents' skills and
capacities while providing a coping strategy has proven effective.
Physicians must remember that they are part of the medical system,
serving their patients - and therefore "to do no harm" is paramount.