L'annonce des mauvaises nouvelles en cancérologie : un dilemme éthique, un travail d'équipe

Breaking bad news to cancer patients requires communication skills beyond those needed to summarize ordinary information. The way the information is delivered to the patient and close relatives can have considerable influence on the patient-care giver relationship throughout the disease course. This situation raises many questions and difficulties for the physician and other members of the healthcare team. It is the main focus of a real ethical dilemma, justified by the singularity of each patient. Whereas, in the past, patients relied totally and trustfully on their doctor, major transformations of medicine and society have led to the development of demands about patient's rights concerning medical decision-making and personal autonomy. In this context, what can we say and how can we avoid having a harmful effect while allowing the patient to remain an autonomous person able to take part in the decision-making process? This study examined within a few onco-hematology units how each professional manages this stage with the patient and relatives, searching for difficulties professionals have coping with this situation. The goal was to determine how a multidisciplinary team can improve their information delivery strategies while preserving a relation of accompaniment full of kindness.