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Medical Errors and Medical Narcissism

Author(s): John Banja, PhD, Emory University, Georgia
Details:
  • ISBN-13: 9780763783617
  • ISBN-10:0763783617
  • Hardcover    229 pages      © 2005
Price: International Sales $97.95 US List
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Overview

Disclosing a harm-causing medical error can be one of the most anguishing conversations a healthcare professional can have. In addition to fears that disclosure might lead to a lawsuit, a harm-causing error can also assault the professional’s sense of competency and adequacy. Often, the necessary conversation between healthcare professional and patient or family is avoided or conducted very poorly.

Medical Errors and Medical Narcissism examines the concept of “medical narcissism” and how error disclosure to patients and families is often compromised by the health professional’s need to preserve his or her self-esteem at the cost of honoring the patient’s right to the unvarnished truth about what has happened. 

This groundbreaking book explores common psychological reactions of healthcare professionals to the commission of a serious harm-causing error and the variety of obstacles that can compromise ethically sound, truthful disclosure. Insights are offered on how talented, capable persons who feel a driving need to demonstrate their competence can fall into narcissistic traps. Guidance on disclosing errors artfully and ethically is provided through a series of step-by-step recommendations along with a list of particularly helpful words and phrases.

This book explores a variety of obstacles that can compromise ethically sound, truthful disclosures of error. It offers numerous observations on tort reform measures and on organizational strategies that can encourage a greater “moral atmosphere” in our hospitals and clinics resulting in improved, patient-centered communications. Readers will find numerous recommendations as to what words to use in disclosing errors artfully as well as ethically. But even more, this book is a sustained examination of how talented, capable persons who feel a driving need to demonstrate their competence and be respected can fall into narcissistic traps.

The “medical narcissist” lives in a world of immense stress and works maniacally hard to be well regarded by his or her colleagues and patients. When a medical error occurs, that world of competence, adequacy and ability is turned upside-down. It is no wonder that even when such persons want to do the right thing and disclose error, they might do it clumsily and make an already bad situation worse. This book offers recommendations as to how these narcissistically-based failures can be remedied such that the only narcissism that exists in health care is a healthy one that enriches the lives of patients and the professionals who care for them.

ShowKey Features

How a medical error should be defined and how serious, harm-causing errors usually occur in institutions

Common psychological reactions of health professionals to the commission of a serious harm-causing error that often leads to concealing the error from the harm party

What ethics says about the moral obligation of the health professional(s) whose error has harmed a patient

How rationalization frequently occurs and discourages the disclosure of medical error

How health professionals, especially physicians, develop narcissistic-like behaviors and attitudes that distance themselves from the experience of what it is like to be a patient, and how that “medical narcissism” diminishes their dealing with any kind of clinical situations that threatens their sense of adequacy, competence, and ability

The value of requesting forgiveness in instances where harm-causing error occurs

Recommendations for 1) managing the current malpractice crisis by way of examining tort reform measures,  2) creating a “just culture” in health care facilities regarding the degree of blame and punishment that health professionals who commit errors should experience, and 3) nurturing more empathic, insightful, non-narcissistic, psychologically healthy health professionals

A step-by-step series of recommendations for disclosing medical error

How health professionals might overcome whatever unhealthy narcissism they have developed

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ShowTable of Contents

Chapter 1:  Error
Chapter 2:  Rationalization
Chapter 3:  Narcissism
Chapter 4:  Forgiveness
Chapter 5:  Case Study
Chapter 6:  Remedies:
Chapter 7:  The Empathic Disclosure of Medical Error
Chapter 8:  Beyond Errors – Beyond Narcissism


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ShowAbout the Author(s)

John Banja, PhD-Emory University, Georgia

John Banja is a clinical ethicist at the Center For Ethics in Public Policy and the Professions and an associate professor of rehabilitation medicine. He received a doctorate degree in philosophy from Fordham University in New York and maintains a specialty interest in moral issues associated with catastrophic neurological impairment. He teaches medical ethics at Emory and has authored or coauthored over 100 publications, including the entry "Rehabilitation Medicine" which appears in the most recent edition of the Encyclopedia of Bioethics.

He has delivered over 500 invited lectures at regional, national, and international conferences and has appeared numerous times on television, radio and in the popular press. He spent the 1998-99 academic year as a Mary Switzer Distinguished Fellow with grant support from the National Institute On Disability and Rehabilitation Research where he studied the ethical dimensions of private health insurance.

He is presently conducting grant funded research on the impact of insurance coverage as an outcome predictor in traumatic brain injury and on communicational strategies for health providers who encounter emotionally painful situations. He was the year 2000 recipient of the John W. Goldschmidt Award for Excellence in Rehabilitation, presented by the National Rehabilitation Hospital in Washington, DC.

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ShowReviews

  • “This book represents important reading for patient safety advocates, ethicists, and medical educators.”

        -Thomas H. Gallagher, MD
          University of Washington School of Medicine

    “Unlike any other book about the disclosure of medical error. Medical Errors and Medical Narcissism helps the reader understand why the act of disclosure is so difficult.”

     - Barbara J. Youngberg, JD, MSW, RN
       Vice President, Insurance, Risk, Quality Management, and Legal Services
        University Health System Consortium
        Author,
    The Patient Safety Handbook

     

    “Even if you think you cannot possibly read another book about medical error, you should read this one.
    John Banja’s exploration of the 'phenomenon of medical error concealment' offers healthcare executives, clinical ethicists, medical educators and others a fresh, engrossing and meticulously researched perspective on this perennial problem. It should be close at hand whenever these professionals are developing better ways to teach, model and maintain ethical practices involving and proceeding from the disclosure of harm.”

     

    Nancy Berlinger, Ph.D, M.Div.
    Journal of Healthcare Risk Management

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