Micro Organizational Behaviour

Today’s Toronto Star has an interesting take on a bill regarding apologies that is currently being considered at Queen’s Park. The bill apparently frees a doctor to say “sorry” for a mistake or outcome, without the fear of having the apology brought into court as an admission of guilt. It is an intriguing proposal, which promises to reduce the number of cases that go to court, because an apology may be all the person needs to forget and move on.

This flavour of apology resembles decaf coffee and light beer: all the good, with none of the bad. The problem is that–and coffee- and beer-drinkers know this–it can’t be the same.

Recall in April 2001 when a U.S. spy plane crashed in China, the Chinese authorities cried out for an apology. What they got was a declaration that the U.S. was “sorry that it happened.” I was living in Japan and the time, working as a translator, and remember the discussion about the translation: “See, he said ’sorry” to them.” True, and somehow he managed not to apologize. Such are the nuances of international diplomacy.

Here, however, we are all speaking English. This bill could do one of two things to exchanges where doctors have to convey bad news to patients.

#1 - Doctors who are genuinely sorry with the result (even though they surely explained the risks going in) can relax and communicate to a fellow human being that they really wish it could have worked out better.

Note: this has the potential to ring very hollow, even if the intent is true. 

#2 - We will see a rise in no-risk lip-service apologies designed to quiet a patient who might otherwise fight back and demand retribution from the system that failed to beat the odds, or at least cover the spread, in a medical procedure. (This is the provincial NDP’s position, as I understand it.)

I think that the benefits from scenario #1 will outweigh the cynical suspicions of #2, so it is a good development. I also think that it is too bad that we have to split the individual apology from the institutional apology. Either way, we lose a bit of the human element, but we all have to minimize the downside. This may be a smart trade off that leads to a better working system.Another option might be for doctors to preface apologies by saying, “The opinion I am about to express comes from my individual feelings, and in no way reflects those of this institution or my profession.”