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Apology protection laws across
Canada
British Columbia Canada's
first Apology Act passed in April 2006 - but only
after the law's sponsor found himself forced to
apologize to opposition members of the legislature
for calling their motion to delay a vote on the
bill "sick," "reprehensible" and dishonourable.
Saskatchewan Apology
protection was added to the Evidence Amendment
Act in May 2007.
Manitoba Dr Jon Gerrard's
Apology Act was passed as in November 2007
and came into force last month after a 90-day
waiting period.
Yukon Legislation proposed
in April 2007 by Liberal MLA Don Inverarity hasn't
yet been put to a vote. "I don't think it will
see the light of day," he told NRM in a
recent interview.
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Last month, Manitoba Liberal leader
Dr Jon Gerrard was visited by a cancer patient in his
office. "There had been some problems that, from the
descriptions I've had, would be classed as medical errors,"
he says.
The patient was a lawyer and "very
cognizant of the issues," as Dr Gerrard puts it. But,
to his surprise, she hadn't come to complain or ask
for help. Instead, she had come to thank him for sponsoring
the Apology Act, the new legislation that came into
force in Manitoba in early February. "She was suddenly
getting 'sorry' and explanations for why the errors
happened," he says proudly. "She was very grateful and
pleased."
On February 8, Manitoba became
the third province to enact apology protection legislation
(see the box below for a run-down of other provinces'
laws). Physicians now have a guarantee they can say
"I'm sorry" without having to worry their apology might
later be introduced as evidence of their guilt in court.
EVIDENCE-BASED
APOLOGIES
American and Australian evidence on doctors' apologies
show improved patient satisfaction, a decrease in repeat
errors and reduced cost and frequency of malpractice
settlements. In many cases, patients and families just
wanted an apology, an admission of responsibility if
it was appropriate, and a reasonable offer of compensation.
After implementing an apology policy
in 2002, University of Michigan hospitals cut their
annual legal costs from $3 million to $1 million and
saw 50% fewer lawsuits and threats to sue. The Canadian
Medical Protective Association (CMPA) says it's too
soon to say whether Canadian apology laws have had a
similar effect.
LAW
OR NO LAW
So is this an idea that you can use in your practice?
Absolutely, says Doug Wojciezsak,
the Illinois-based author of Sorry Works!, an
apology strategy book published in January. He got involved
in the apology business after his brother died as the
result of a medical error in 1998; the family never
heard the word sorry from doctors. A disclosure and
apology policy, as he calls it, can work for you even
if you don't practise in one of the provinces where
apology protection legislation has been passed.
"These apology laws are really
legal nothings," he claims. "It's been okay all along
to say sorry." According to lawyers quoted in Sorry
Works!, a well-documented apology is hard for the
prosecution to beat. After all, what malpractice lawyer
wants to draw attention to the defendant's contrition,
honesty and good will? In fact, the CMPA says its advice
to doctors doesn't change whether or not their province
has apology legislation: if a thorough investigation
determines you messed up, you should apologize.
"It's a 180 in thinking," says
Mr Wojciezsak. "I tell doctors, 'For god's sake, learn
about legal strategy.' They think it's the error that
kills them in court, but it's not. It's the cover-up."
His advice? Set up a disclosure and apology policy in
your practice, clinic or hospital. His book, which is
available online at www.sorryworks.net
and includes a CME test on apologizing, offers a five-step
process for developing a policy of your own.
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PATIENTS & PRACTICE
