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“You are the registrar on the ward and the daughter of a woman who is under investigation for lung cancer pulls you aside on the ward to have a quick word. The diagnosis has been confirmed today that the patient has cancer, and the daughter was called in by the mother, to be told together.”

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This communication skills station is difficult.

The concerned and distressed relative jumps straight in, and the doctor, rightly, checks who she is and what her relationship to the patient.

The law is very clear in the UK here which is that, without permission from the patient, information cannot be given to anyone other than the patient.

The daughter is very persistent and continues to push for verbal and non-verbal answers.

The doctor is very clear and has to say this a number of times. The doctor, is also sympathetic to the daughter’s worry, and acknowledges her distress, but gently, but firmly, tells her that she is unable to give specific information.

The doctor also provides information about how the information will be given, in a caring and sympathetic manner. Also, it is up to the patient how much information she wants to receive.

The daughter, is turns out, has had a very difficult situation with another person in her family, and this is driving her fears. The doctor keeps re-iterating that the patient has to be given the information and that further tests and treatments cannot occur without the patient knowing why.

It is important to acknowledge that this is difficult for the relative, but not give information that you have not been given permission by the patient to give.