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The SPIKES protocol will be discussed in the context of working with a patient who was referred to palliative care in the hospital setting. Palliative care is complex because it is not only medical care but also emotional and spiritual care. Those working in palliative care often explain a diagnosis to the patient, both what the diagnosis is and what it likely means for the future. The SPIKES protocol, a conversational tool for delivering bad news, has applications for social workers. This case study will tell the story of a patient whose fear of death almost cost him the ability to live fully at the end of his life and how the SPIKES tool was implemented in helping this patient understand and come to terms with his diagnosis.

In 1974, President Ford began the arduous task of healing the wounds sustained by the United States during the Vietnam War. His controversial clemency plan gave those who had either deserted the military or those who evaded the draft the chance to earn their way back into American society. President Ford was willing to face this opposition to move the country closer to resolving an issue that was tearing the nation apart. In the applications to Ford's Presidential Clemency Board, thousands of deserters and evaders reveal their motivations, and in doing so present a large body of evidence that contradicts the usual perception of the Vietnam "draft-dodger" and deserter. In the transition between the hardline anti-clemency position of President Nixon, and the full clemency position of President Carter, Ford took strong measures to achieve resolution, and the evidence herein could suggest a reappraisal of the Ford presidency.