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Could doctors be protected for saying, "I'm sorry"?
In 2006, actor James Woods’ brother Michael died of a heart attack at Kent Hospital in Warwick, R.I. Woods, a native of Warwick, sued the hospital, claiming emergency room staff members were negligent and didn’t do enough to save his brother. In the end, Woods settled the lawsuit primarily because a Kent hospital executive subsequently apologized.
This Wednesday, Woods is set to testify before a state legislative committee in support of a new “benevolent gestures” bill, introduced by Rhode Island Representative Joseph McNamara, which would allow doctors to apologize for the outcomes of negative treatment, but prohibit those apologies from being used against them in malpractice lawsuits.
There are 36 states that currently have apology laws in one form or other. Most exclude admissions of sympathy (“I’m sorry”) from being used in malpractice suits. Eight states also exclude admissions of fault (“I screwed up!”) as evidence of guilt. California law protects doctors if they choose to apologize, but if they admit guilt, that could be used against them. Research shows that medical malpractice claims tend to drop off when health practitioners apologize for mistakes and other harmful outcomes.
The climate of deny-and-defend might be shifting, but that doesn’t mean it’s easy for doctors and nurses to express regret – or that it happens regularly. Malpractice is an ugly system that can quickly become adversarial. It’s not unreasonable for doctors who’ve been creamed by malpractice suits to be hesitant about admitting to any less-than-perfect outcomes.
The full pdf of the proposed bill:
But should they anyway? What are the pros and cons of apology laws? Do they protect doctors at the expense of patients? Or all they good prescriptions for everyone? If you’re a doctor, have you ever told a patient you were sorry? How’d it go? As for the rest of you, can you remember a time a doctor EVER ‘fessed up to being fallible? Did it make a difference?
Robert M. Wachter, MD, Professor and Associate Chairman, Department of Medicine, University of California, San Francisco (UCSF); Author of the forthcoming 2nd Edition of Understanding Patient Safety; and Chair-Elect of the American Board of Internal Medicine