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Breaking bad news of cancer to people with learning disabilities



Accessible summary

  • • When some one gets cancer the doctor, most times, tells them about it and does not keep it a secret.
  • • Because this can be very upsetting, the government pays for special training to help doctors and nurses to do this well.
  • • The training does not include anything about the needs of people with learning disabilities.
  • • Some people with learning disabilities were asked whether the doctor had told them when they were ill, and most of them said ‘no’.
  • • Learning disability staff need to help doctors and nurses understand how to speak to people with learning disabilities. People with learning disabilities need to understand about their illness and be involved in decisions about their treatment.


Since the 1970s, medical staff have routinely disclosed the diagnosis of cancer to their patients. However, this has often been carried out unskilfully causing distress to the patient and impairing their ability to comply with treatment. In response, the government has invested in ‘Advanced Communication Skills training’ for oncology staff. Despite the subsequent advances made in communicating with the general public, this article will show that a small-scale audit of people with learning disabilities demonstrated that often doctors do not communicate directly with people with learning disabilities about serious illness. It will also suggest that, the current ‘breaking bad news’ models do not meet the communication needs of people with learning disabilities. This article explores the findings of the audit and its implications for practice and ends by sign posting to useful resources for communicating the bad news of a life-threatening illness to people with learning disabilities.