New search
download case
  • Overview
  • Teaching Notes
  • Comments/Replies

To Tell the Truth

Delivering Bad News to Patients

Co Authors:

Doug Knutson
Family Medicine
The Ohio State University College of Medicine

Doug M. Post
Family Medicine
The Ohio State University College of Medicine


This case was developed to teach first-year medical students about medical ethics as they apply to patient communication. Students receive an introductory lecture covering the basics of giving bad news and then are asked to apply what they have learned to a real-life medical situation they read about. The case describes a man who, recently retired, is looking forward to a cruise trip with his wife, but he hasn’t been feeling well. Medical tests show he has colon cancer. Assuming the role of the physician, students must decide when and how to break the bad news. To prepare for their role, students learn the six-step protocol for breaking bad news developed by medical oncologist Dr. Robert Buckman, which they then apply to the case.

  • Discuss whether or not patients want to know bad news.
  • Discuss physician strategy for giving bad news as it relates to timing, content, and delivery.
  • Discuss thoughts regarding who should deliver bad news to a patient (primary care physicians versus specialists).
  • Apply the Buckman protocol for delivering bad news to patients.
Keywords: Medical ethics; physician-patient communication; bad news; truth-telling; Buckman protocol; Robert Buckman; colon cancer
Topical Area: Ethics
Educational Level: Graduate, Professional (degree program), Continuing education
Formats: PDF
Type/Method: Dilemma/Decision, Role-Play
Language: English
Subject Headings: Medicine (General)   Nursing   Communication Science  
Date Posted: 02/02/06
Date Modified: N/A
Copyright: Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

Teaching Notes

Case teaching notes are password-protected and access to them is limited to paid subscribed instructors. To become a paid subscriber, begin the process by registering here.

Teaching notes are intended to help teachers select and adopt a case. They typically include a summary of the case, teaching objectives, information about the intended audience, details about how the case may be taught, and a list of references and resources.

  Download Teaching Notes

City State:
security code
Enter Security Code: