As it turned out that the pregnancy was ectopic, my doctor’s tone shifted from joyful to empathetic

Some years ago I taught a class in medical school on “Breaking Bad News”. I never liked the title, but I inherited it and was not allowed to change it. So I used it to deconstruct what we meant by “breaking” and “bad”. We know that assumptions by a clinician on whether it is “good” or “bad” news impacts how it’s delivered to a patient. In turn, that delivery, along with the news itself and the patient’s own view on its value, influence a patient’s response.

To encourage students to consider the complexity around giving news a value, I used invented examples. These were: a) telling someone they had a particular diagnosis, which on the face of it appears to be bad news, but gives a name and the attendant social validity to a patient’s symptoms; and b) telling someone they were pregnant, which might seem like good news when that might not be the case.

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