Apologising after a medical or surgical mishap
No doctor goes into work in the morning intending to harm a patient; however, medical errors do and always will occur, occasionally with devastating consequences.
Statutory duties of candour now require clinicians to provide a factual explanation and apologise after a notifiable incident. Following the well-publicised Bawa-Garba case many doctors have become concerned that an apology, especially a written apology admitting fault, could place the clinician in an unfavourable position in subsequent disciplinary or criminal proceedings. For example, a doctor whose error had unfortunately led to a patient’s death might find their apology admitted for evidence in a charge of gross negligence manslaughter.
Saying sorry for a medical error is a doctor’s ethical and professional duty. A proper apology can demonstrate respect and empathy to patients and their family, lessen distress and reduce the risk of subsequent legal action. Conversely, failure to apologise, or an evasive partial apology, may increase the psychological distress and exacerbate a dispute.
Most apologies for medical mishaps are delivered before all the facts behind how an event occurred are fully understood. Speculation regarding causation should always be avoided as these are often unhelpful to all those concerned. The guidance from the Medical Protection Society is helpful in this respect and clearly recommends that clinicians in this unenviable situation should state: ‘I am so sorry that this happened to you’, rather than ‘I am so sorry that this happened to you, and it was my fault because…’.
What are your views? Have you ever been in a situation when you have found it necessary to apologise, or admit fault, to a patient?