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Part 1: Why this book is necessary; who should read this book; a brief note about the format; objectives; why it is worth doing well; should we tell the truth?; who should break the bad news?. Part 2 Why breaking bad news is difficult: a definition of bad news; why bad news is bad; greater difficulty - facing death. Part 3 Basic communication skills: Professional listening; why patients are unhappy; the basic steps of the medical interview; professional versus social dialogue. Part 4 Breaking bad news - a six-step protocol: some general comments; the six-step protocol. Part 5 The patient's reactions: general hints in responding to reactions; specific reactions. Part 6 Other peoples' reactions: reactions of family and friends; doctor's reactions; issues between members of the health care team; ethical and legal issues; cultural issues.