There's a book called "The Anatomy of Hope" by Dr. Jerome Groopman which is a series of short stories about Groopman's experiences, particularly his failings, as a doctor. It's interesting because he clearly tries to do right and yet it doesn't always turn out as he hoped. There are two stories that sort of book end the complexity.
Early in his career he had an experience with a patient where he was following the lead of a more experienced physician. When the patient achieved remission, the doctor chose to emphasize the remission and not discuss the likelihood of recurrence. The patient asked, "Am I cured?" and the doctor said "You're on your way to remission." Without further discussion, the patient took it to mean she was out of the woods. Groopman didn't choose what info was communicated, but he admits that not discussing the differences between remission and cure made the visit easier. Groopman had his doubts about what they were communicating, but he went with it anyway. The physician in charge told him "sustained ignorance is a form of bliss." When the cancer returned, the patient and her daughter were devastated. The daughter spoke to Groopman and said "I guess he didn't think people like us are smart enough or strong enough to handle the truth." And Groopman responded, "It wasn't a question of smart enough. And it wasn't specific to your mom and you. We were trying to spare you the worry." The daughter then said, "Well, you were both wrong."
Groopman felt ashamed and guilty. He knew he had failed the patient and her daughter. He vowed not to make the same mistake again and began to be direct with his patients about their disease and prognosis. He told one woman that a remission would likely last between three and six months and that a person could expect to survive one to two years. Groopman felt he was communicating in the right way because he was clearly and completely informing his patient. The patient had an excellent response to chemo. Groopman later learned from the patient's husband, after the patient had died, that the months of remission were not months that were enjoyed. The patient was consumed with thoughts of her presumed expiration date.
As Groopman laments, these two patients were not the only two to suffer from his "ineptitude" as he struggled to find a balance. He also notes that the doctor who had been overseeing him was later diagnosed with cancer and that his experience as a patient changed him profoundly. He had come to realize that ignorance is not bliss. That truth and hope can coexist. But it took being a patient himself before he really understood the consequences of his communication.
Anyway, it just seems like there are no easy answers when it comes to communication. If anyone is looking for an interesting read, "The Anatomy of Hope" is fascinating.