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Maintaining trust


Stating that you are sorry for the circumstances or the condition of the patient is appropriate at every disclosure meeting. Genuine concern and regret by a caring physician and healthcare team will be appreciated by most patients and families.

How should you say you are sorry for a poor clinical outcome? The answer depends on the reason for the outcome:

  • If it is the result of the progression of the underlying medical condition:
    An expression of concern and sympathy is sufficient and will be appreciated by your patient and the family.

  • If it is related to an inherent risk of an investigation or treatment:
    An expression of regret should be provided, such as "I feel badly that this happened to you." An apology (with acceptance of responsibility) should not be provided.

  • If it is related to system failures or provider performance, as determined after careful analysis:
    An apology should be considered by the responsible provider or responsible organization. In these circumstances, it is appropriate to acknowledge responsibility for the harm and to apologize. Relevant examples might include mistakenly administering a different than prescribed medication, operating on the wrong patient, or not acting on an important finding because of a lost lab report.
The use of words that express or imply legal responsibility, such as negligence or fault, or reference to failing to meet the standard of care, should be avoided and are not part of disclosure. Such legal determinations are complex, and independent bodies such as the courts and medical regulatory authorities (Colleges)
Regulatory authority, professional:  Licensing body for a profession.
Provincial/territorial medical regulatory authority (College)
Body that regulates the practice of medicine in each province or territory to ensure the public receives quality medical care from physicians. The responsibilities include:
- Issuance of certificates of registration to allow the practice of medicine,
- Maintenance of standards of practice,
- Investigation of complaints against physicians, and
- Remedial education or discipline for those guilty of professional misconduct or incompetence.
The medical profession is self-regulating in Canada. Each authority has an investigative process and committee structure to make decisions on different issues and complaints.
 have the responsibility to make these determinations fairly.