Breaking bad news.

Breaking bad news has been ignored in the past and still depends largely on culture and social state. We experience now a strong trend towards full information in modern societies. The article describes the typical stages patients go through when dealing with bad news. Recommendations how to break bad news stress the importance of privacy and enough time, the necessity to learn how much knowledge is pre-existing, to wait until the patient signalizes readiness, to give the information in small, understandable portions, to recognize and encourage emotions and to sum up and schedule further meetings. A special appraisal of the situation in gastrointestinal endoscopy is given.