SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer

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  • Walter F. Baile
    The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  • Robert Buckman
    The Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada
  • Renato Lenzi
    The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  • Gary Glober
    The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  • Estela A. Beale
    The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  • Andrzej P. Kudelka
    The Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada

Description

<jats:title>Abstract</jats:title><jats:p>We describe a protocol for disclosing unfavorable information—“breaking bad news”—to cancer patients about their illness. Straightforward and practical, the protocol meets the requirements defined by published research on this topic. The protocol (SPIKES) consists of six steps. The goal is to enable the clinician to fulfill the four most important objectives of the interview disclosing bad news: gathering information from the patient, transmitting the medical information, providing support to the patient, and eliciting the patient's collaboration in developing a strategy or treatment plan for the future. Oncologists, oncology trainees, and medical students who have been taught the protocol have reported increased confidence in their ability to disclose unfavorable medical information to patients. Directions for continuing assessment of the protocol are suggested.</jats:p>

Journal

  • The Oncologist

    The Oncologist 5 (4), 302-311, 2000-08-01

    Oxford University Press (OUP)

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