Balancing Rights and Responsibilities of Key Stakeholders in Addressing Reports of Disrespect Experienced by Patients.

Professionalism in health care occurs in environments that present complex ethical dilemmas that demand ideal individual and team performance. Clinicians who behave unprofessionally toward patients and family members create a disproportionate share of risk for adverse patient outcomes and malpractice claims. However, when made aware, the vast majority will self-regulate. Several options exist for a clinician who observes or hears about an interaction between a colleague and a patient or family member that does not seem to be consistent with the organization's commitment to treat individuals with respect and dignity. Responses to unprofessional behavior need to recognize and balance the rights and responsibilities of key stakeholders, including patients, clinicians, coworkers, and the organization. In one approach, the clinician would speak directly with the colleague to make them aware of the event and encourage them to consider alternative approaches in future similar interactions. Alternatively, the clinician could ensure that the story is reported, reviewed, and shared through the organization's professional accountability program. Professional accountability programs must be supported by appropriate infrastructure elements. Sharing the observation helps to address the concerns and fears of patients and family members, offers a colleague the chance to reflect and reduce the likelihood of future unprofessional behavior, and seeks to fulfill one's individual responsibility to support colleagues as professionals, while striking the right balance of dignity, respect, and pursuit of trust for all key stakeholders.