Tuesday, April 23, 2019

Supreme Court to decide about apology: Will the Apex Court’s decision on apology have implications on medical mistakes?



Dr KK Aggarwal

Yesterday, the Congress president Rahul Gandhi expressed regrets in the Supreme Court over his remarks related to Rafaele.

If the Apex Court decides to accept the apology of Rahul Gandhi, this will provide another tool for councils to decide about medical apology.

The council has powers to accept the mistake. As per Regulation 8.2 of MCI Code of Ethics, “…If the medical practitioner is found to be guilty of committing professional misconduct, the appropriate Medical Council may award such punishment as deemed necessary or may direct the removal altogether or for a specified period, from the register of the name of the delinquent registered practitioner…”.

Apologies are gaining in importance, both nationally and internationally. These started with the example set by Pope John Paul II in his numerous apologies on behalf of the "children of the church" in anticipation of the Jubilee Year, as well as redress through national apologies to various groups-including Japanese Americans interned during World War II; Native Americans, whose land was confiscated and were otherwise mistreated; African Americans, whose ancestors were victims of slavery; and particular African Americans, who were victims of medical tests such as the "Tuskegee Experiment."

The importance of the apologies of healthcare professionals-particularly physicians and hospital leaders through their risk management personnel-to their patients for medical errors became an important matter in medical education and practice around 2000.

There have been at least five converging forces leading to the current interest in medical error apology.

1.     The physician-patient relationship is more egalitarian than ever before. Patients are now apt to be informed consumers-due in part to the Internet and popular advertising-who feel that they have the right to negotiate their treatment and know when mistakes have been made.
2.     The American medical community's knowledge about the frequency and seriousness of medical errors has been growing, and many believe that such knowledge and disclosure to patients will ultimately improve medical practice. Such disclosure is now required by the Joint Commission on Accreditation of Healthcare Organizations.
3.     Once doctors disclose a serious medical error to a patient, it is only common wisdom for medical professionals to apologize for psychological and humanitarian reasons. Patients would inevitably perceive withholding an apology in such circumstances as offensive, insensitive, and unprofessional.
4.     Physicians and other medical staff in several medical centers have successfully diminished the costs of malpractice suits by apologizing to patients for medical errors and, when appropriate, making out-of-court settlements.
5.     Several states in USA have passed or are considering legislation that would allow supportive, benevolent comments, as well as apologies, to be inadmissible in malpractice cases, thereby encouraging physicians to offer such comments and apologies.

Lawyers have always advised physicians and other healthcare professionals to refrain from apologizing to patients, because they believed that offering an apology is an admission of guilt, which would increase the frequency and amount of malpractice claims.

This assumption is changing and today many believe that such apologies are not only ethically correct but may even decrease such claims.

“Hushing up’ of errors increases results in an angry patient and creates distrust between the doctor and the patient. 

Apologize to the patient in such situations…While it does not undo the damage caused, an apology may soothe the emotions of the patient and/or the family and lessen the anger and distrust.

Let us see what the apex court decides…

(Source: De Paul University)

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA


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