Introduction


Breaking bad news is one of the biggest challenges for doctors as the communication is complex and involves intense emotion. Hence, it requires communication skills to facilitate the flow of information in a beautiful and acceptable manner.

Bad news is typically associated with a terminal diagnosis, but there are many situations that involve delivering bad news; for example, delivering ultrasound results regarding fetal abnormalities, or informing parents and a young child on the diagnosis of insulin dependent diabetes.

SPIKES is a step-by-step protocol that provides strategies towards effective breaking bad news.