December 05, 2018

Assuming blame for a medical error may help patients and families heal.

Although assuming blame for a medical error may involve negative psychological effects for the practitioner, patients and families of patients who have been harmed are able to move forward knowing that the mistake is being taken seriously. An article published in the Journal of Medical Ethics explored the current blame culture pervasive in the medical field.

Between 44,000 and 98,000 deaths occur in the United States each year because of medical errors. Some have suggested that medical education should evolve to include how to disclose medical errors, apologize, meet patients’ needs, and take responsibility for mistakes.

In an era that seeks to move away from fixing the blame toward fixing the problem, Daniel W. Tigard, of the Human Technology Center at RWTH Aachen University in Aachen, Germany, argues that we should retain the idea of blame and responsibility as well as the associated emotions of guilt, regret, and remorse in healthcare settings. He notes that those who experience those emotions are in a better position to offer sincere apologies.

Dr Tigard admits that not all medical errors are preventable. He uses the example of a nurse in an oncology unit responsible for the care of 5 patients because of understaffing at the hospital. In this scenario, 2 patients suddenly need life-saving interventions at the same time. The nurse is able to save only one patient, while the other dies. Although she may be tempted to blame the system, Dr Tigard contends that the nurse should apologize to the family, as it offers the best chance of healing.

Although the current argument often runs that accepting blame hinders systemic changes because medical professionals fear being sued and may be tempted to cover up mistakes, Dr Tigard suggests that accepting blame and offering apologies for medical errors may in fact decrease the risk for malpractice lawsuits. Patients who have been harmed because of a medical error often want to prevent others from experiencing the same errors. There is also evidence to suggest that clinicians who accept blame for errors are more likely to learn from their mistakes and improve their practices than those who do not.

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Reference

Tigard DW. Taking the blame: appropriate responses to medical error [published online November 9, 2018]. J Med Ethics. doi:10.1136/medethics-2017-104687