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Doctors and patients feel the same after medical errors

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39380.679039.80 (Published 01 November 2007) Cite this as: BMJ 2007;335:908

When doctors make serious mistakes they feel guilty, afraid, and alone. Patients and families harmed by those mistakes feel the same guilt, the same fear, and the same isolation say two US doctors who interviewed victims of medical error while making a film.

Relatives feel guilty because they weren't around to protect their loved one. Patients and families fear retribution or poor care if they speak out. Both emotions are exacerbated when doctors back away, too paralysed by their own feelings to speak openly, discuss their mistakes, and maybe even say sorry. Hospital managers, lawyers, and insurers don't help by telling doctors to choose their words carefully and avoid accepting liability. The result is an impersonal dialogue that seems cold and uncaring.

About 30 US states already have “I'm sorry” laws under which doctors' comments to patients after a medical error are inadmissible for the purposes of establishing fault. These laws should be universal, say the doctors. It is also time to build a formal structure for coping with the aftermath of medical error that removes stigma and supports direct and sympathetic communication. Whatever that structure finally looks like, patients and their families must help to build it.

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