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This article discusses strategies for delivering serious news. Several common frameworks are identified (ABCDE, BREAKS, SPIKES, Nurse). It is written from a physician perspective.

Abstract: "Delivering serious, bad, or life-altering news to a patient is one of the most difficult tasks physicians encounter. Broadly defined as information that may alter a patient's view of his or her future, bad news may include information related to a chronic disease (e.g., diabetes mellitus), a life-altering illness (e.g., multiple sclerosis), or an injury leading to significant change (e.g., a season-ending knee injury). Patients prefer to receive such news in person, with the physician's full attention, and in clear, easy-to-understand language with adequate time for questions. Most patients prefer to know their diagnosis, but the amount of desired details varies among different cultures and by education level, age, and sex. The physician should respect the patient's unique preferences for receiving bad news. Physicians may experience stress related to providing bad news that extends beyond the actual conversation...There are several algorithms available to help guide the physician in the delivery of bad news, including the SPIKES protocol (setting, perception, invitation, knowledge, emotion, and strategy and summary). Skillful delivery of bad news can provide comfort for the patient and family."

About the organization: American Family Physician (AFP) is the AAFP's editorially independent, peer-reviewed and evidence-based clinical journal. Published monthly in print and online, AFP delivers concise, easy-to-read clinical review articles for physicians and other health care professionals.