SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer WALTER F. BAILE,a ROBERT BUCKMAN,b RENATO LENZI,a GARY GLOBER,a ESTELA A. BEALE,a ANDRZEJ P. KUDELKAb a The University of Texas MD Anderson Cancer Center, Houston,...
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SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer WALTER F. BAILE,a ROBERT BUCKMAN,b RENATO LENZI,a GARY GLOBER,a ESTELA A. BEALE,a ANDRZEJ P. KUDELKAb a The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; b The Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada Key Words. Neoplasms · Physician-patient relations · Truth disclosure · Educational models A BSTRACT We describe a protocol for disclosing unfavorable information, providing support to the patient, and elic- information—“breaking bad news”—to cancer iting the patient’s collaboration in developing a stra- patients about their illness. Straightforward and prac- tegy or treatment plan for the future. Oncologists, tical, the protocol meets the requirements defined by oncology trainees, and medical students who have been published research on this topic. The protocol taught the protocol have reported increased confidence (SPIKES) consists of six steps. The
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