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Home StrategiesAnswering
difficult questions |
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When an individual has absorbed and understood the bad news message,
there will often be a number of questions arising. Many of the answers
contain more bad news and uncertainty. Some common questions, following
a diagnosis of a life threatening or terminal illness, are: -
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Why me?
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Will I get better?
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How could this have happened?
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How long have I got?
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Is there a heaven?
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What happens after.?
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Such questions are difficult because, often, the answer will offer
uncertainty at best. What is important here is to find out why the
question is being asked and what it really means, for many patients,
and relatives, ask such questions when they have some idea of what
the answer might be, and are looking for confirmation.
A useful strategy is to reflect the question back to the patient in
an empathetic way:
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I can see that this is difficult for you, but I wonder why
you are asking that question just now?
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That is a hard one. I'll try to answer, but how does it look
to you?
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The problem is that we just don't know. What do you think?
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By reflecting back in this way, the patient has the opportunity to
expand on his/her concerns, but also to retract the question if they
regret it. "Why me" questions often contain elements of guilt that
the patient may feel contributed to the present situation, whereas
"Will I get better" type questions are usually asked when a patient
realises that his/her condition may be terminal.
Some difficult questions are asking for our personal opinion. These
include questions about life after death. Rather than discussing our
own faith, it is useful to reflect back and explore what the patient
believes. As with other difficult questions, they may be looking for
confirmation of their own thoughts:
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"Do you believe in heaven, doctor?"
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| Doctor |
"Well, I'm not sure, but the important thing is - what do
you believe?"
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| Patient |
" I'd like to believe that my wife will be waiting for me
up there. She died two years ago"
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| Doctor |
"Would it help for you to speak to the chaplain here?"
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| Patient |
"No, well I mean, I wondered if my own Vicar would come in"
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In the above exchange, the patient had thought about death and what
happens afterwards. By reflecting his question back to him, the real
reason for his question emerged as the need to talk to his own vicar.
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Denial
