How 9/11 thinking can impair doctors' clinical judgmentBMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7393.829 (Published 12 April 2003) Cite this as: BMJ 2003;326:829
- Ralph Crawshaw, retired psychiatrist
- Portland, Oregon, United States
In preparing an address to the Western Institutional Review Board on the climate of medical morality in the north western United States, an unusual psychological phenomenon surfaced—9/11 thinking. The apparent prevalence of 9/11 thinking and its effect on clinical judgment merits wide consideration.
In preparatory talks with medical colleagues I discovered that American doctors' thinking has changed. Asking, “How do you feel?” usually elicited the answer “Fine.” Only when I repeated the answer back to them—“Fine?”—did speakers pause to think.
Subsequent responses were not what I might have expected. “Now that you ask, I do not feel fine. I feel anxious.” “I am angry and confused.” “I do not know what to feel about this war.” A visiting Canadian doctor said, “There is an elephant in the room and US doctors do not talk about it. If I say anything, I fear being misinterpreted.”
Have current events altered doctors' capacity to reflect?
As strong emotions surfaced, colleagues were understandably cautious. Only as they …