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Apology in cases of medical error disclosure: Thoughts based on a preliminary study

BACKGROUND: Disclosing medical errors is considered necessary by patients, ethicists, and health care professionals. Literature insists on the framing of this disclosure and describes the apology as appropriate and necessary. However, this policy seems difficult to put into practice. Few works have...

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Autores principales: Dahan, Sonia, Ducard, Dominique, Caeymaex, Laurence
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536280/
https://www.ncbi.nlm.nih.gov/pubmed/28759586
http://dx.doi.org/10.1371/journal.pone.0181854
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author Dahan, Sonia
Ducard, Dominique
Caeymaex, Laurence
author_facet Dahan, Sonia
Ducard, Dominique
Caeymaex, Laurence
author_sort Dahan, Sonia
collection PubMed
description BACKGROUND: Disclosing medical errors is considered necessary by patients, ethicists, and health care professionals. Literature insists on the framing of this disclosure and describes the apology as appropriate and necessary. However, this policy seems difficult to put into practice. Few works have explored the function and meaning of the apology. OBJECTIVE: The aim of this study was to explore the role ascribed to apology in communication between healthcare professionals and patients when disclosing a medical error, and to discuss these findings using a linguistic and philosophical perspective. METHODS: Qualitative exploratory study, based on face-to-face semi-structured interviews, with seven physicians in a neonatal unit in France. Discourse analysis. RESULTS: Four themes emerged. Difference between apology in everyday life and in the medical encounter; place of the apology in the process of disclosure together with explanations, regrets, empathy and ways to avoid repeating the error; effects of the apology were to allow the patient-physician relationship undermined by the error, to be maintained, responsibility to be accepted, the first steps towards forgiveness to be taken, and a less hierarchical doctor-patient relationship to be created; ways of expressing apology (“I am sorry”) reflected regrets and empathy more than an explicit apology. CONCLUSION: This study highlights how the act of apology can be seen as a “language act” as described by philosophers Austin and Searle, and how it functions as a technique for making amends following a wrongdoing and as an action undertaken in order that neither party should lose face, thus echoing the sociologist Goffmann’s interaction theory. This interpretation also accords with the views of Lazare, for whom the function of apology is a restoration of dignity after the humiliation of the error. This approach to the apology illustrates how meaning and impact of real-life language acts can be clarified by philosophical and sociological ideas.
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spelling pubmed-55362802017-08-07 Apology in cases of medical error disclosure: Thoughts based on a preliminary study Dahan, Sonia Ducard, Dominique Caeymaex, Laurence PLoS One Research Article BACKGROUND: Disclosing medical errors is considered necessary by patients, ethicists, and health care professionals. Literature insists on the framing of this disclosure and describes the apology as appropriate and necessary. However, this policy seems difficult to put into practice. Few works have explored the function and meaning of the apology. OBJECTIVE: The aim of this study was to explore the role ascribed to apology in communication between healthcare professionals and patients when disclosing a medical error, and to discuss these findings using a linguistic and philosophical perspective. METHODS: Qualitative exploratory study, based on face-to-face semi-structured interviews, with seven physicians in a neonatal unit in France. Discourse analysis. RESULTS: Four themes emerged. Difference between apology in everyday life and in the medical encounter; place of the apology in the process of disclosure together with explanations, regrets, empathy and ways to avoid repeating the error; effects of the apology were to allow the patient-physician relationship undermined by the error, to be maintained, responsibility to be accepted, the first steps towards forgiveness to be taken, and a less hierarchical doctor-patient relationship to be created; ways of expressing apology (“I am sorry”) reflected regrets and empathy more than an explicit apology. CONCLUSION: This study highlights how the act of apology can be seen as a “language act” as described by philosophers Austin and Searle, and how it functions as a technique for making amends following a wrongdoing and as an action undertaken in order that neither party should lose face, thus echoing the sociologist Goffmann’s interaction theory. This interpretation also accords with the views of Lazare, for whom the function of apology is a restoration of dignity after the humiliation of the error. This approach to the apology illustrates how meaning and impact of real-life language acts can be clarified by philosophical and sociological ideas. Public Library of Science 2017-07-31 /pmc/articles/PMC5536280/ /pubmed/28759586 http://dx.doi.org/10.1371/journal.pone.0181854 Text en © 2017 Dahan et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Dahan, Sonia
Ducard, Dominique
Caeymaex, Laurence
Apology in cases of medical error disclosure: Thoughts based on a preliminary study
title Apology in cases of medical error disclosure: Thoughts based on a preliminary study
title_full Apology in cases of medical error disclosure: Thoughts based on a preliminary study
title_fullStr Apology in cases of medical error disclosure: Thoughts based on a preliminary study
title_full_unstemmed Apology in cases of medical error disclosure: Thoughts based on a preliminary study
title_short Apology in cases of medical error disclosure: Thoughts based on a preliminary study
title_sort apology in cases of medical error disclosure: thoughts based on a preliminary study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536280/
https://www.ncbi.nlm.nih.gov/pubmed/28759586
http://dx.doi.org/10.1371/journal.pone.0181854
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