Breaking the Bad News in Cancer: An In-Depth Analysis of Varying Shades of Ethical Issues

Abstract

AbstractOncology has a range of ethical issues that are difficult to address and breaking the bad news is probably the most important and common across the world. Conventionally, breaking the bad news has been exclusively used in the situation where definitive diagnosis of cancer is to be conveyed to the patient. On a practical note, for the treating doctor, breaking the bad news is not restricted only to the confirmation of cancer and its prognosis at the initial diagnosis but also includes conveying futility of curative treatment, changing from curative to palliative treatment, recurrence/metastasis posttreatment, end of life care, and finally informing death of the patient to the family members. In addition to this, informing pregnant women that she has been diagnosed with cancer, about surgery-induced body disfigurement, loss of fertility due to chemotherapy/ radiotherapy, and of treatment-induced irreversible health complications are also challenging for the treating oncologist. On the basis of an in-depth analysis, the current review presents the various situations, complexities, and the related ethical issues in breaking the bad news in various situations from the perspective of an oncologist in detail in Indian context.