title: Apologizing for humiliations in medical practice.
abstract: Apologizing to patients and their families for medical mistakes is an increasingly accepted practice. Overlooked is the need to apologize to other members of the treatment team or patients for humiliations inflicted in medical practice, independent of medical mistakes. A humiliated treatment team member or patient is apt to undermine optimal care, particularly when teamwork or patient adherence to treatment is required. This article describes the psychology of humiliation and the history of humiliation in medical practice, including why doctors and patients are vulnerable to being humiliated. Several humiliation narratives are presented. This article presents empirical data based on a sample of 355 subjects that analyze what the offended party seeks in an apology and the magnitude of the importance of each of these desires. The restoration of dignity in response to humiliation emerges as one of the most important functions of apologies. Finally, this article identifies 15 healing forces of apology, a combination of which is necessary for healing any given offense. The final challenge is educating individuals as to how to apply these findings to healing after a humiliating offense.
authors.affiliation: Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA. Electronic address: aaron.lazare@umassmed.edu.
authors.forename: Aaron
authors.initials: A
authors.lastname: Lazare
authors.affiliation: Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA.
authors.forename: Roselle Sherman
authors.initials: RS
authors.lastname: Levy
mesh_terms: D001291:Attitude of Health Personnel; D030881:Disclosure; D006801:Humans; D019300:Medical Errors / Q000941:ethics*; D010817:Physician-Patient Relations / Q000941:ethics*; D012649:Self Concept