Medical errors: Disclosure styles, interpersonal forgiveness, and outcomes

Area of Science:

• Medical error disclosure
• Patient forgiveness
• Physician-patient relationship

Background:

• Investigates intrapersonal and interpersonal factors in patient forgiveness after medical errors.
• Examines antecedents predicting patient forgiveness and non-forgiveness.

Purpose of the Study:

• Assess social-cognitive factors (fault attributions, empathy, rumination) influencing forgiveness.
• Evaluate disclosure styles and their impact on forgiveness models and outcomes.

Main Methods:

• 318 outpatients randomly assigned to hypothetical error disclosure vignettes.
• Vignettes varied nonverbal disclosure styles (high involvement, low involvement, written).
• Patients completed forgiveness-related self-report measures.

Main Results:

• Proximity model favored: patient rumination and empathy were stronger predictors of forgiveness than offense factors.
• Physician nonverbal involvement significantly influenced outcomes: low involvement led to higher perceived error severity, less sincere apologies, more blame, less empathy, and less forgiveness.
• Low nonverbal involvement correlated with increased distress, avoidance, doctor switching, and legal action likelihood.

Conclusions:

• Physician nonverbal involvement in error disclosures promotes healing and strengthens the physician-patient relationship.
• Nonverbally uninvolved disclosures increase malpractice risk and hinder reconciliatory outcomes.