Tuesday, October 30, 2007
The New England Journal of Medicine published a commentary recently concerning the emotional toll of medical mistakes - both on family members of the loved ones injured by the mistake and by the doctors. The New York Times ran a brief piece on the commentary and an upcoming documentary about medical mistakes this past weekend.
The New England Journal of Medicine tackled the [emotional toll of medical mistakes] issue yesterday in a moving commentary called “Guilty, Afraid and Alone: Struggling with Medical Error.’’ The writers, Dr. Tom Delbanco and Dr. Sigall K. Bell of the Harvard Medical School, note that while the medical community has focused largely on reducing error rates, hospitals also need to address the “human dimensions” of treatment blunders and to assist in the emotional recovery of patients and families.
The doctors, who are making a documentary film on the subject, talked to numerous patients and families affected by medical errors. The authors found that family members often feel guilty for not having protected loved ones from the caregivers’ mistakes and that many feared retribution if they did complain. And Dr. Delbanco and Dr. Bell note that physicians who err often shut out patients and their families, “isolating them just when they are most in need.’’
When mistakes happen, relatives often berate themselves for not keeping close watch on their loved ones. In one case cited in the commentary, the family of a man with sickle cell anemia repeatedly warned health care workers not to administer morphine. But somehow it happened anyway, sending the man into kidney failure and a coma. “The feeling was impotence, because you can’t stay with a patient 24 hours a day,’’ said his sister. “That’s why you rely on hospitals — you rely on nurses. You feel like you failed your family in terms of ‘I should have been there.’ That’s a guilt that everyone shares.” . . . .
Several family members said that they simply wanted their doctors to talk to them and to explain how the mistake had happened. “What we needed was for someone to reach out and connect with us in human terms,” said one. “The sense that somebody could empathize and know what I was feeling . . . that was almost totally lacking.”
The authors note that honest and direct communication are often the “best antidote” to flawed treatment. Patients and families also want to know that some good has come out of these mistakes, and that the event has taught both caregivers and their institutions.