Tuesday, March 28, 2006

Your Truth: "I Want to Call My Wife." Part 2

Your differing answers to this dilemma suggest that there isn't one right answer, but I will offer my thoughts and experience.

Death is an expected outcome in hospice and palliative care, therefore lawsuits over unrightful death are unlikely. However, I believe that the media's attention to the need for apologies in the light of medical malpractice may be extended to "mistakes" such as the one described in my previous post.

The Lancet recently published some data from research being done on the disclosure of medical errors:

"...patients were asked what they would have wanted to hear at the time of an incident. What they described was wanting to learn what happened, that someone would accept responsibility, that steps were being taken to prevent future similar incidents, and they wanted an apology."

Having heard that and having a personal policy of being honest and open, I decided to tell this patient's wife the truth.

When she arrived to the patient's bedside, I sat down beside her. I said, "I was there when your husband died. I want you to know that it was a very peaceful death."

I then continued, "I also want to tell you that last night, your husband asked the night nurse if he could call you. He seemed confused. The nurse explained to him that it was 2am and assured him we'd call you in the morning. He was doing so well yesterday, we were not expecting him to die so soon..."

I put my hand to my heart and tears filled my eyes (I was very sincerely distressed by this course of events).

I continued, "And it breaks my heart that we didn't call you. I'm so sorry."

The apology was sincere and heart-felt. Did this leave her anxiously wondering what her husband had wanted to say? Or did it offer her some comfort that he was thinking of her in his last hours? I can't say.

But in my heart, this disclosure felt like the right decision. She did not express any anger; instead, she seemed relaxed and comforted by my honest admission of our fault.

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