Mea Culpa: Apology Legislation, Accountability and Care

Abstract

Increasingly, jurisdictions are adopting “apology legislation” that allow medical professionals to apologize to patients and family members when an adverse event occurs while disallowing the introduction of the apology in a liability case as evidence of fault or liability. While apology legislation itself is fairly straightforward, its potential meaning and impact is much more complex. This paper conceptualizes apology legislation from an accountability and ethics of care perspective. These two concepts—accountability and care—are distinct but interrelated concepts and this dual theoretical approach offers a rich analysis on the potential impact(s) of apology legislation. We argue that apology legislation is a mechanism added to the existing accountability regime that can offer important opportunities to express and practise care. As an accountability mechanism, apology legislation creates space for an accountability relationship to emerge between medical professionals and their patients. Apology legislation also addresses long-standing gaps in how we as a society think about health care and respond to patients and families in ways that challenge the dominant “consumer of services” role. It is in this sense that apology legislation has the potential to destabilize traditional notions of social citizenship. Last, we argue that empirical research is urgently needed to know to what degree apologies contribute to accountability and the transformation of health care.