Pending Massachusetts Bill Lets Doctors/Nurses Apologize For “Unanticipated Outcome”

Massachusetts has been in the forefront of patient safety legislation.  This session House Bill 1519 has been approved by the Committee on Public Health for further action.  The name of the bill is ” An act reducing medical errors and improving patient safety.”

The bill addresses several areas of patient safety including hospital patient safety checklists,examination of overuse of care including CT and other imaging, medication errors, and screening for MRSA.  For me, the most remarkable part of this bill is the encouraging of  medical professionals to apologize for a medical error without it being liable or admission of malpractice.

Section 7 of the law defines “unanticipated outcomes” as “ the outcome of a medical treatment or procedure, whether or not resulting from an intentional act that differ from an intended result of such medical treatment or procedure.”

The bill goes on to state that if there is an unanticipated outcome and the medical professional  or institution apologies (lists various methods of apology), then             “the unanticipated outcome shall be inadmissible as evidence in any judicial or administrative proceeding and shall not constitute an admission of liability or a statement against interest.”

This bill does not take away a patients right to sue.  It does say very clearly that the apology cannot be used in the lawsuit.  I am sure, if this bill becomes law, it will tested in court.  It is a remarkable first step as a result of four Representatives, Health Care for All and numerous patient safety advocates.

It  has not been easy for medical professionals to apologize for many reasons.  The most obvious is the fear of  litigation.  Institutions have no mechanism to support a doctor/nurse to apologize and feel supported.  As DN  Frenkle and LB Liebman stated in a 2004 article “Words That Heal”, in the Annals of Internal  Medicine,        ” Apologies have a potential for  healing that is matched only by the difficulty most people have in offering them.”

Medical professionals are not trained how to deal with an outcome that may cause harm to a patient.  They have not been given the communication skills to adequately apologize.  Knowing harm has occurred can eat away at a person’s self  confidence and views of themselves.  When an apology is offered, it can help both the patient and the medical professional.

This bill offers hope for more apologies and discussion with patients and families when an error occurs.  Medical errors cause such anguish and pain for both sides.  By opening this door, it can help to foster understanding and communication instead of anger, confusion and malpractice.

Here is a link to the bill.      For all Massachusetts residence, call your representative.                                                                                                            http://www.hcfama.org/_data/n_0001/resources/live/H%201519%20redraft%20-%20as%20reported%20out%20bu%20public%20health.pdf