In all areas of medicine there is increasing awareness that patients need information that is clear, relevant and appropriately timed. This is obviously connected with ethical concerns of patient dignity and autonomy, but it also underpins the principle of informed choice. It is not possible to make an informed choice about how you want a problem to be managed, if you do not have the relevant information. Doctors have, historically, been poor communicators of such information. Although, on the face of it, this seems a straightforward issue to rectify, there are a surprising number of practical problems to be addressed before such communication can become a reality in daily practice.