Apologies and Medical Error

Abstract

One way in which physicians can respond to a medical error is to apologize. Apologies-statements that acknowledge an error and its consequences, take responsibility, and communicate regret for having caused harmcan decrease blame, decrease anger, increase trust, and improve relationships. Importantly, apologies also have the potential to decrease the risk of a medical malpractice lawsuit and can help settle claims by patients. Patients indicate they want and expect explanations and apologies after medical errors and physicians indicate they want to apologize. However, in practice, physicians tend to provide minimal information to patients after medical errors and infrequently offer complete apologies. Although fears about potential litigation are the most commonly cited barrier to apologizing after medical error, the link between litigation risk and the practice of disclosure and apology is tenuous. Other barriers might include the culture of medicine and the inherent psychological difficulties in facing one's mistakes and apologizing for them. Despite these barriers, incorporating apology into conversations between physicians and patients can address the needs of both parties and can play a role in the effective resolution of disputes related to medical error.

Doctors’ experiences of adverse events in secondary care: the professional and personal impact

“…[13][14][15][16][17][18] There is a growing body of evidence to suggest that clinicians who directly or indirectly contribute to the occurrence of an adverse event can experience psychological effects that disrupt their professional and personal lives, as well as their ability to deliver high-quality, safe care. [18][19][20][21][22][23] Anxiety, depression, sleep disturbance, fear and worry are consistently reported by those involved in adverse events, as are shame, guilt, loss of selfconfi dence, and feelings of incompetence and worthlessness.…”

Wrong-Site Procedures: Preventable Never Events that Continue to Happen

“…It has long been established that honesty and apologetic stance both decrease, rather than increase, the likelihood of subsequent blame and anger [46][47][48][49]. Humble and honest acknowledgment, along with an authentic apology, can also improve the relationship and increase trust between the involved physician and patient or their family [46,48,50,51]. By the time, it was discovered that significant damage occurred as a result of WSP, it was too late for any form of reconciliation outside of the legal system.…”

Comunicación de errores médicos a pacientes y familiares: interrogantes y herramientas

“…Por el contrario los datos tienden a mostrar que las explicaciones, disculpas, reconocimiento y responsabilidad por el daño inflingido disminuyen la probabilidad de una demanda legal 10,11 .…”

“…Existiría una cultura médica que es reticente a las fallas 16 . Se ha sugerido la existencia de una serie de mitos respecto a los médicos incluyendo el que deben saberlo todo, no cometer errores y que no se ven afectados por necesidades, emociones ni enfermedades.…”