A recent study published in Mayo Clinic Proceedings advises physicians to avoid specific phrases when speaking with critically ill patients to prevent creating false hope or causing emotional harm. Researchers identified 12 “never phrases” that they argue fail to provide comfort and may even accentuate power imbalances between doctors and patients.
Phrases like “Everything will be fine” and “withdrawing care” are discouraged because they can either give unrealistic optimism or imply that doctors are “giving up” on a patient. Instead, researchers recommend phrases that maintain honesty without abandoning emotional support, such as, “I’m here to support you throughout this process.”
The research team—comprising three medical professionals and one former critically ill patient—based their recommendations on both personal experience and feedback from 20 physicians. They urge doctors to communicate in ways that avoid setting unrealistic expectations, as this can be more beneficial and compassionate for patients facing serious illnesses.
For instance, rather than saying, “There is nothing else we can do,” doctors should instead express options that could still improve the patient’s quality of life, even if a cure is no longer possible. This approach emphasizes that treatment continues, even if the goal shifts to comfort and symptom management.
The report also warns against using phrases that imply blame or criticism, such as “I don’t know why you waited so long to come in.” Blame can worsen the patient’s emotional state and hinder trust. A better alternative would be a supportive acknowledgment like, “I’m glad you came in when you did,” which focuses on moving forward constructively. Similarly, doctors are encouraged not to cast judgment on other physicians’ previous actions with phrases like, “What were your other doctors thinking?” Instead, they should foster a collaborative environment by saying, “Let’s look at your records and see where we can go next.”
Language that frames illness as a “fight” or “battle” is discouraged as well. These terms can make patients feel guilty if they don’t recover, implying that a lack of recovery results from not fighting hard enough. Instead, the study recommends framing the situation as something they “face together,” emphasizing support and understanding rather than attributing success to sheer willpower alone. By removing combative language, doctors can help patients focus on realistic, supportive outcomes without unnecessary pressure.
The report also suggests avoiding phrases like “Do you want us to do everything?” which could misalign with a patient’s values and provoke anxiety. A more open-ended approach like, “Let’s discuss the available options if the situation worsens,” invites patients and their families to engage in discussions about care choices in a way that respects their perspectives and personal wishes. This approach fosters a more inclusive decision-making process, allowing patients and families to feel involved rather than pressured.
The authors of the study advocate for a shift towards “dialogue-centered” care, where clinicians use language that empowers patients and encourages shared decision-making. They argue that by eliminating “never phrases,” doctors can improve trust and make patients feel more involved in their treatment, which is essential for effective care. This communication approach could help rebuild public trust in the medical field, which, according to a recent Gallup poll, has declined significantly since the pandemic began, with fewer Americans rating doctors’ ethics and honesty highly.
