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In a "Sorry" State: The Ethics of Institutional Apologies in Response to Medical Error

The rise in prominence of public apologies since the mid 1990s and increased awareness of the frequency and severity of medical errors in the United States has led to scholarly and professional interest in doctors apologies in response to medical error. Literature targeting health care professionals indicates a growing consensus about the ethical and professional imperatives for apology. However, it also exposes the authors difficulty in achieving conceptual clarity about apology and its application to modern clinical practice carried out by multiple providers within complex medical, legal, and insurance systems.
This project articulates the ethical underpinnings of apology and establishes ethically and professionally appropriate responses--both by clinicians and administrators of health care institutions--to medical error. Foundationally, this argument includes clarifying salient distinctions related to medical error and adverse events and conceptualizing apology as it is applicable to health care contexts. In sum, a policy or culture of responsibility--to which apology may instrumentally contribute--is ethically valuable and contributes to overall quality of care in contemporary health care institutions. The roles and responsibilities of clinicians and administrators within a culture of responsibility are discussed, in addition to the structure, applications, limitations, and ethical considerations of policies regarding apology.

Identiferoai:union.ndltd.org:PITT/oai:PITTETD:etd-04202009-132523
Date04 June 2009
CreatorsBoyer, Autumn R.
ContributorsLisa S. Parker, John Lyne, Mark Wicclair
PublisherUniversity of Pittsburgh
Source SetsUniversity of Pittsburgh
LanguageEnglish
Detected LanguageEnglish
Typetext
Formatapplication/pdf
Sourcehttp://etd.library.pitt.edu/ETD/available/etd-04202009-132523/
Rightsunrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report.

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