The goal is to convey threatening information in a way which promotes understanding, recall, and support for the patient;s emotional response and a sense of ongoing support.

NONDISCLOSURE IS THE TRADITIONAL MODEL THAT WAS USED IN BREAKING BAD NEWS ABOUT CANCER. A PATERNALISTIC MODEL OF THE PHYSICIAN PATIENT RELATIONSHIP THAT THE PHYSICIAN SHOULD DECIDE WHAT IS BEST FOR THE PATIENT, UNDERLIES THE USE OF A NONDISCLOSURE MODEL. THIS ASSUMES THAT THE PATIENT DOES NOT WANT TO KNOW BAD NEWS AND NEEDS TO BE PROTECTED FROM BAD NEWS. ADVANTAGES INCLUDE THE FACT THAT THIS IS TIME EFFICIENT, EASIER FOR THE MD. POOR FOR THE PATIENT AS THERE ARE LOST OPPORTUNITIES TO HELP PATIENTS ADJUST AND TO PROVIDE INTERVENTIONS-LITERATURE HAS FAILED TO SUPPORT THIS APPROACH*

FULL DISCLOSURE IS BASED ON THE ASSUMPTION THAT ALL PATIENTS WANT TO KNOW BAD NEWS AND THAT PATIENTS HAVE THE RIGHT TO FULL INFORMATION AND TO MAKE TREATMENT DECISIONS. THIS MAY NOT BE THE BEST MODEL FOR ALL PATIENTS, AS SOME MIGHT FEEL OVERWHELMED AND FRIGHTENED BY TOO MUCH DETAIL.

GIRGIS ET AL. ASSERT THAT INDIVIDUAL DISCLOSURE APPEARS TO BE THE BEST MODEL. THIS MODEL RECOGNIZES THAT PEOPLE ARE DIFFERENT IN THEIR PREFERENCES FOR INFORMATION AND THAT TAKING IN AND ADJUSTING TO BAD NEWS CAN TAKE TIME. THUS, INDIVIDUAL DISCLOSURE MODEL IS ADVANTAGEOUS BECAUSE IT ALLOWS FOR A TAILORING OF THE AMOUNT OF INFORMATION AND RATE OF DISCLOSURE, WHICH CAN LEAD TO A SUPPORTIVE PHYSICIAN PATIENT RELATIONSHIP. THIS MAY BE MORE TIME CONSUMING BUT IS ASSOCIATED WITH THE BEST ADAPTATION FOR THE PATIENT.

USE BODY LANGUAGE TO LET THE PATIENT KNOW THAT BAD NEWS WAS COMING.

FOR INSTANCE, USING GRADE 8 LANGUAGE AS A REFERENCE.