Betrayal Trauma: Impact on Health Professionals

"Second victims" are clinicians who are traumatized after an unanticipated adverse patient event, medical error, or patient-related injury. Less recognized is the profound sense of betrayal and trauma that can occur in the context of patient deception. The implicit patient-healthcare provider contract assumes that patients are truthful with providers so they may obtain accurate diagnoses and effective treatments. Betrayal by deception can feel like a traumatic death; not of a person, but of a previously intimate and trusting relationship. Healthcare professionals are no better at detecting lies than the lay public and hold inaccurate beliefs about detectable signs of deception. Thus, healthcare professionals may be more vulnerable to betrayal by deception than they realize. The 2 clinical cases presented here reveal the ease with which healthcare providers can be misled, emotionally manipulated by individuals who superficially appear to be psychologically healthy and traumatized by betrayal by deception.