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

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...

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Bibliographic Details
Published in:The oncologist (Dayton, Ohio) Ohio), 2000-08, Vol.5 (4), p.302-311
Main Authors: Baile, Walter F., Buckman, Robert, Lenzi, Renato, Glober, Gary, Beale, Estela A., Kudelka, Andrzej P.
Format: Article
Language:English
Subjects:
Communication
Decision Making
Educational models
Humans
Neoplasms
Physician-Patient Relations
Prognosis
Truth Disclosure
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Summary: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.
ISSN:1083-7159
1549-490X
DOI:10.1634/theoncologist.5-4-302