Handling difficult questions in palliative care--a flow diagram.

Patients with advanced disease ask many difficult questions, some of which have painful answers, some of which have answers which contain uncertainty, and some of which have no answers. They should be able to ask their questions in an environment that allows them to disclose their true worries, have the opportunity to talk them through, and look for options. Health professionals need to develop the relevant skills to help patients and their families to disclose and discuss difficult issues, while handling their own emotions.