Abstract of V. Gross-Tsur lecture

HOW TO DELIVER "BAD NEWS"

V. Gross-Tsur

Shaare Zedek Medical Center, Israel

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.