An experimental investigation of the dilemma of delivering bad news |
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| Institution: | 1. Department of Psychology, University of Victoria, Canada;2. British Columbia Cancer Agency, Vancouver Island Centre, Canada;3. Division of Palliative Care, University of British Columbia, Canada;1. Faculty of Psychology and Educational Sciences, University of Bucharest, Panduri Avenue, No. 90, Bucharest 50663, Romania;2. University of Groningen, Department of Psychology, The Netherlands;1. School of Advertising and Public Relations, Hongik University, F410, 2639 Sejong-ro, Jochiwon-eup, Sejong, Republic of Korea;2. School of Advertising and Public Relations, Hongik University, F407, 2639 Sejong-ro, Jochiwon-eup, Sejong, Republic of Korea;3. School of Advertising and Public Relations, Hongik University, F513, 2639 Sejong-ro, Jochiwon-eup, Sejong, Republic of Korea;1. Massachusetts Institute of Technology, Department of Brain & Cognitive Sciences, 43 Vassar St., Building 46, Cambridge, MA, 02139, USA;2. University of Oslo, Department of Philosophy, Georg Morgenstiernes Hus, Blindernveien 31, Oslo, 0313, Norway;1. Northwestern University, United States;2. University of Oregon, United States |
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| Abstract: | ObjectiveThis randomly controlled experiment tested a theory of how experienced physicians solve the dilemma of communicating bad news by using implicit language.Methods8 physicians delivered both bad and good news to 16 analogue patients. Microanalysis of their news delivery reliably identified departures from explicit language.ResultsAs predicted, the physicians used implicit language at a significantly higher rate when delivering bad news than good news. For bad news, they tended to use alternative terms for the diagnosis, to qualify their evaluation, to underemphasize certainty, and to subtly separate the patient from the disease. The evidence both within and after the interview indicated that recipients still understood the bad news.Conclusion(1) The skilful use of implicit language is a solution to the dilemma of honest but not harsh communication of bad news. (2) Experimental methods can complement surveys and qualitative studies for investigating bad news delivery by providing a theoretical foundation and controlled conditions.Practice implicationsPhysicians can deliver bad news honestly without being blunt by skilfully incorporating implicit language. The theory, data, and examples presented here provide insights into the nature and functions of implicit language, from which students and practitioners can develop their individual styles. |
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