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  1. Understanding PLAB 2: The Foundation Course
  2. /
  3. Module 3: Difficult Conversations

Understanding PLAB 2: The Foundation Course

Course Progress
0 of 45 lessons completed (0%)
Module 1: Understanding PLAB 2
4
Module 2: The Consultation Toolkit
9
Module 3: Difficult Conversations
6
Module 3 Introduction
Lesson 3.1: Breaking Bad News: SPIKES and Bereavement
Lesson 3.2: Delivering Unwanted Results and Chronic Diagnoses
Lesson 3.3 : Counselling Stations: Understanding Before Explaining
Lesson 3.4 : Angry Patients, Difficult Relatives, and Self-Discharge
Lesson 3.5: Communicating with Relatives and Third Parties
Module 4: Ethics and Professionalism
9
Module 5: Examination Stations
8
Module 6: Procedures, Emergencies, and Prescribing
9

Lesson 3.5: Communicating with Relatives and Third Parties

Module 3: Difficult Conversations

Lesson 3.5: Communicating with Relatives and Third Parties

Your legal and ethical duty of care is to your patient. Information about your patient belongs to your patient. Before sharing anything with a third party, including relatives, you must either have the patient's consent or be acting under a recognised confidentiality exception.

Common Third-Party Scenarios

ScenarioYour Approach
"I don't want my mother told her diagnosis" Acknowledge that the son is acting out of love. Explain that your duty is to your patient. Explore what he thinks his mother would want. If your patient has capacity and wishes to know, you must not withhold that information. Offer to have a conversation with the patient about how much involvement she wants from family.
Spouse or relative requesting clinical information — patient has capacity 'I completely understand why you want to know — you're worried and you love her. Unfortunately I'm not able to share specific clinical information without her permission. I would encourage you to speak with her directly. If she's happy for me to share information with you, I would be very happy to do that.'
Relative calling to ask about test results — patient is incapacitated You may share relevant information on a need-to-know basis if it is in the patient's best interests. Document what you shared and why.
After death — relative asking about cause Confidentiality continues after death. You may share information to help bereaved relatives understand the cause of death, considering what the patient would have wanted in life.

Communicating Through an Interpreter

When a patient does not speak English, always use a professional telephone or face-to-face interpreter, not a family member.

  • Family members may censor information, add their own opinions, or be placed in a deeply difficult position.
  • Address the patient, not the interpreter: speak to the patient directly — 'Mrs Khan, how long have you...' — and let the interpreter relay.
  • Speak in shorter chunks — pause after 1–2 sentences to allow accurate interpretation.
  • Check understanding directly with the patient: 'Have you understood what I've explained?'
  • Document that an interpreter was used and record their details.