Breaking bad news to people with learning disabilities: A literature review

Accessible Summary A literature review was undertaken to explore reasons why relatives, staff and healthcare professionals choose to tell or not tell people with learning disabilities bad news. People with learning disabilities' views on being told bad news are discussed. The author looks at who should tell people with learning disabilities bad news. The author found that relatives, staff and healthcare professionals have different reasons for telling and not telling people with learning disabilities bad news. The author suggests talking about bad news is important. Background Methods This article provides a literature review exploring reasons for disclosure and nondisclosure of bad news to people with learning disabilities. Connections are made to current policy, law and ethics to highlight the complexity of this issue. This review examines literature on disclosing bad news to people with learning disabilities from 2007 to 2017. A total of 13 articles were found with nine articles having a direct focus on breaking bad news. Results Conclusions The main themes identified from this review are maintaining rights and dignity, upholding duty of care, underestimating resilience, protection from harm and capacity to understand. Exploration of who should disclose is examined in reference to relatives, staff and healthcare professionals. Trends surrounding disclosure of diagnosis and prognosis to people with learning disabilities have not kept pace with the trend to disclose with the general population. People with learning disabilities are frequently not informed of their terminal diagnosis and often die without this knowledge. Equally, bad news concerning a friend or relative may also be withheld.