BREAKING BAD NEWS TO PATIENTS (SPIKES PROTOCOL)
Keywords:
Breaking bad news; SPIKES protocol; medical communication; cross-cultural communication; linguistic strategies; modal verbs; hedging; patient-centered care; empathy in medicine; doctor–patient interaction; cultural differences; medical discourse.Abstract
Delivering bad news to patients is one of the most ethically and emotionally demanding responsibilities in medical practice. Effective communication in such situations requires not only clinical competence but also linguistic sensitivity and cultural awareness. This article examines the use of the SPIKES protocol as a structured framework for breaking bad news in English-speaking medical contexts and analyzes the specific linguistic strategies employed, including modal verbs, hedging devices, warning shots, and collaborative language.
Through a comparative analysis, the study contrasts English communication patterns with those commonly observed in Russian medical discourse, highlighting differences in directness, emotional framing, patient involvement, and professional hierarchy. The findings demonstrate that English medical communication tends to prioritize empathy, patient autonomy, and shared decision-making, while Russian communication traditionally emphasizes clarity, authority, and efficiency.
The paper argues that these differences are deeply rooted in broader cultural values and significantly influence patient perception, emotional response, and therapeutic trust. Understanding these linguistic and cultural distinctions is essential for improving cross-cultural medical communication and enhancing patient-centered care in diverse clinical settings.
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