Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA.
Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA.
Chest. 2011 Apr;139(4):746-751. doi: 10.1378/chest.10-3334.
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.
向患者及其家属就医疗失误道歉，这种做法已越来越被接受。然而，人们却忽略了这样一种必要，即在医疗实践中，即便不存在医疗失误，也需要向治疗团队的其他成员或患者道歉，因为他们也可能受到了羞辱。受到羞辱的治疗团队成员或患者很可能会破坏最佳治疗效果，尤其是在需要团队合作或患者配合治疗的情况下。本文描述了羞辱的心理和在医疗实践中羞辱的历史，包括医生和患者为何容易受到羞辱。本文还呈现了几个羞辱的事例。本文基于对 355 名受试者的样本提供了实证数据，分析了被冒犯方在道歉中寻求什么，以及这些愿望的重要程度。对羞辱的回应是恢复尊严，这是道歉最重要的功能之一。最后，本文确定了 15 种道歉的治疗力量，这些力量的结合对于治愈任何特定的冒犯都是必要的。最后一个挑战是教育个人如何将这些发现应用于受到羞辱后的治疗。
