When doctors make mistakes
There are many more serious examples of inadequate apologies: cases where mistakes made by the health services have led to injury or death without the doctors responsible and other health personnel apologising. Such incidents make a strong impression and create distance between patients and their families on the one hand and health personnel on the other.
People are not stupid. They understand that doctors are people, that to err is human, and that doctors and other health personnel sometimes make mistakes, also mistakes with a fatal outcome. And most next of kin can accept a lot. However, non-disclosure, secrecy and poor excuses are difficult to accept and can make loss and the grieving process even harder.
Why is it so difficult to apologise? Partly because it is not normally one doctor or one nurse who alone bears responsibility for a serious incident such as an unexpected death. Who was actually at fault when the routines failed? Who should really say 'Sorry' – the senior consultant, the hospital director or the doctor on duty when the incident in question took place? Another reason why apologies are difficult to make is that we are trained not to make mistakes. We have too little training in taking the blame. Put simply, we lack a culture for saying to a colleague who has made a serious mistake, 'It could just as well have been me. I hope this doesn't mean that you are considering giving up your job as a doctor. Making mistakes is unfortunately part of the job, even though we do everything we can to avoid it'.
Sometimes patients die unexpectedly without it being anyone's fault, without any errors having been made, for example because the patient had a paradoxical reaction to a medication, medical procedure or operation. It may be difficult for the next of kin to understand and accept this. In such cases, the general public's expectations of medicine in general may play a role. We should preferably be able to cure the patient regardless. In such cases it is not an apology that is needed but empathy. The doctor must set aside time, sit down with the next of kin and give a detailed and lucid explanation of what happened and why. It is then easier for the next of kin to move on.
Openness and clarity are prerequisites for good communication. So obvious, and so important.