Exploring the Phenomenon of Physicians' Apologies Following Medical Errors
akhlāq-i pizishkī i.e., Medical Ethics,
Vol. 14 No. 45 (1399),
30 March 2020
,
Page 1-14
https://doi.org/10.22037/mej.v14i45.28231
Abstract
Background and Aim: Despite the many efforts made by hospitals, the pace of medical error reduction is still slow, many errors will undoubtedly occur and thousands of patients and physicians suffer from medical errors. Members of healthcare organizations generally do not receive training to disclose medical errors and apologize to the damaged person; they may refuse to disclose errors, apologies, or may have other reactions. It is worth noting that this study aims to investigate the phenomenon of physician apology following medical errors.
Materials and Methods: The research method is qualitative (interview based) with the conventional content analysis approach. Data were collected through semi-structured interviews with a purposeful selection of 25 physicians and senior assistants working in Shahid Mohammadi, Children, and Persian Gulf hospitals in Bandar Abbas. Data analysis was performed using MAXQDA 10 software.
Findings: The study identified three overarching themes )antecedents, physicians' apologies phenomena, consequences(, eight organizing themes (medical community norms, social factors, individual factors, Components of apologies, apology conditions, achieving of social acceptance, internal and external pressures( and 27 basic themes.
Ethical Considerations: To comply with ethical considerations, the ethics research with the code ir.hums.rec.1397.237 received from the Ethics Committee. Written consent was first given to the volunteers to participate in the study, and after consent was obtained, permission was given for interview and note-taking. They were assured of the confidentiality of their personal information.
Conclusion: Fear of legal consequences and loss of credibility makes doctors more cautious in apologizing, but the factors of education, culture, and personality traits facilitate the presentation and acceptance of apology. On the other hand, apologizing improves relationships between the patient and the doctor and prevents problems such as stress and legal follow-up.
Cite this article as: Bagheezadeh T, Zarghamifard M, Heyrani A. Exploring the Phenomenon of Physicians' Apologies Following Medical Errors. Faṣlnāmah-i akhlāq-i pizishkī i.e., Quarterly Journal of Medical Ethics. 2020; 14(45): e7.
- Medical Error; Apology; Thematic Analysis; Qualitative Research
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References
Hurwitz B, Sheikh A. Health care errors and patient safety. USA: John Wiley & Sons; 2011.
Leone D, Lamiani G, Vegni E, Larson S, Roter DL. Error disclosure and family members’ reactions: Does the type of error really matter? Patient Education and Counseling 2015; 98(4): 446-452.
Sherwood W. To err is human. Ed.USA: John Wiley & Sons; Transfusion 1990; 30(7): 579-580.
Sherwood WC. To err is human… Alexander Pope, An Essay on Criticism. Ed.USA: Wiley Online Library; Transfusion 1990; 30(7): 579-580.
Westrick SJ, Jacob N. Disclosure of errors and apology: Law and ethics. The Journal for Nurse Practitioners 2016; 12(2): 120-126.
Prothero MM, Morse JM. Eliciting the functional processes of apologizing for errors in health care: Developing an explanatory model of apology. Global Qualitative Nursing Research 2017; 4: 2333393617696686.
Prothero MM, Morse JM. Eliciting the Functional Processes of Apologizing for Errors in Health Care. Global Qualitative Nursing Research 2017; 7: 1-9.
Alberstein M, Davidovitch N. Apologies in the healthcare system: From clinical medicine to public health. Law and Contemporary Problems 2011; 74(3): 151-175.
Saitta SDH. Is it unrealistic to expect a doctor to apologize for an unforeseen medical complication? a primer on apologies laws. Pennsylvania Bar Association Quarterly 2011.
Lazare A. On Apology. USA: Oxford University Press; 2005.
Leape LL. Full disclosure and apology - an idea whose time has come. Physician Executive 2006; 32(2): 16.
Walfisch T, Van Dijk D, Kark R. Do you really expect me to apologize? The impact of status and gender on the effectiveness of an apology in the workplace. Journal of Applied Social Psychology 2013; 43(7): 1446-1458.
Ho B, Liu E. Does sorry work? The impact of apology laws on medical malpractice (SSRN Scholarly Paper No. ID 1744225). Rochester, NY: Social Science Research Network; 2010.
Robbennolt JK. Apologies and legal settlement: An empirical examination. Michigan Law Review 2003; 102(3): 460-516.
Lochlann Jain S. How to do Responsibility: Apology and Medical Error. No Place: No Name; 2009. p.1-25. Available at: https://www.anthropology. stanford.edu/sites/g/files/sbiybj9346/f/jain.apology.pdf.
Boyer AR. In a "Sorry" State: The Ethics of Institutional Apologies in Response to Medical Error [Master Thesis]. USA: University of Pittsburgh; 2009.
Alberstein M, Davidovitch N. Apologies in the healthcare system: From clinical medicine to public health. Law and Contemporary Problems 2011; 74(3): 151-175.
Mazor KM, Greene SM, Roblin D, Lemay CA, Firneno CL, Calvi J, et al. More than words: patients’ views on apology and disclosure when things go wrong in cancer care. Patient Education and Counseling 2013; 90(3): 341-346.
Nazione S, Pace K. An experimental study of medical error explanations: do apology, empathy, corrective action and compensation alter intentions and attitudes? Journal of Health Communication 2015; 20(12): 1422-1432.
Carmack HJ. A cycle of redemption in a medical error disclosure and apology program. Qualitative Health Research 2014; 24(6): 860-869.
Zarei F,SheikhZakariai N, Ardalan M, Daneshkhah N. Evaluation of honesty and apology in nurses that serving patients from the viewpoints of patients. Scientific Journal of Nursing, Midwifery and Paramedical Faculty 2016; 1(4): 57-64. [Persian]
Narimani AR, Vaezi R, Alvani SM, Ghorbanizadeh V. Identifying External Organizational Barriers and Factors of Commercialization of Humanities Research at Universities. Journal of Management and Development Process 2017; 30(1): 81-110. [Persian]
Dahan S, Ducard D, Caeymaex L. Apology in cases of medical error disclosure: Thoughts based on a preliminary study. PloS One 2017; 12(7): e0181854.
Coombs WT, Frandsen F, Holladay SJ, Johansen W. Apologizing in a globalizing world: Crisis communication and apologetic ethics. Corporate Communications: An International Journal 2010.
JK R. Apologies and medical error. In Clinical Orthopaedics and Related Research 2009; 467(2): 376-382.
Vines P. Apologising for personal injury in law: Failing to take account of lessons from psychology in blameworthiness and propensity to sue. Psychiatry, Psychology and Law 2015; 22(4): 624-634.
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