Patient Comprehension via Explanatory Communication—Reply

In Reply In their Letter about our recent article, Dr Back and colleagues highlight a particular sentence in the Table: “Palliative care is not hospice care and it is not giving up,” and indicate that this phrasing may be problematic due to its use of negation. The sentence is an example of an elucidating explanation, a technique that we discussed in the article as a way to clarify a concept by explaining both what it is (affirmation) and what it is not (negation). The negation is not intended to stand alone. Instead, the elucidating explanation is part of a larger conversation about palliative care. In the case we described in the Table, the clinician conversation began in the patient scenario row, including an introduction to palliative care, which would describe what palliative care is (affirmation statement). The elucidating explanation, including the negation statement, then helps patients navigate the information that came in the affirmation statement.