Communication between physicians and patients has multiple dimensions like the content of the dialogue, effective component and behaviours other than verbal. Communicating bad news appropriately demands proper knowledge of the disease and its prognosis and good communication skills (Back and Arnold, 2006). The improper manner of delivery of bad news not only leads to uneasiness but also a poor psychological adjustment for the patients and their close relatives (Mager and Andrykowski, 2002). Receiving bad news is a situation of crisis for the patient. The patient expresses the severest form of anxiety, uncertainty, confusion, fear of losing control over his or her life and helplessness. Following certain recommendations as far as communicating bad news is concerned helps physicians deliver the news effectively. Prioritization is the first step in the process of preparation to deliver bad news (Metzger et al, 2008). The physician must identify certain key points which the patient must retain. He must also analyze what to expect from the patient after the encounter and what decisions must be taken at the end of the meeting. In the case of James, points to be prioritized are cancer of the bowel with multiple metastases. After prioritizing, the physician must prepare to deliver the news. The discussion must be rehearsed and a location which is private and with an uninterrupted environment should be selected for the meeting.