Should doctors apologize to their patients when they have made a mistake? Tom Delbanco thinks so.

Himself a doctor, and a long-time professor at Harvard Medical School, Tom urges his fellow physicians to adopt this practice. In an opinion piece on the New York Times web site, he and a colleague, Dr. Sigall K. Bell, argue the benefits of taking this approach to medical error.

They believe that it will help everyone concerned if physicians say they are sorry. But simply saying these words does not suffice. In addition, patients and family members need to understand what happened. And the institution must provide assurance that the same mistake will not occur in the future.

Tom Delbanco, a neighbor of mine, has had a long and distinguished medical career. He is also a creative thinker who takes patient-centered care as one of his vital concerns.

He and his colleague, Dr. Bell, emphasize the range of emotions that both patients and those close to them experience when medical error occurs. They often feel fear, guilt, and isolation, unless doctors maintain personal contact with them.

When things go wrong, patients and their loved ones find themselves burdened by a loss of trust in their doctors and fear of retribution if they protest. Unless some kind of closure is made available to them, they are likely to become angry and even vindictive.

The doctors, for their part, are also likely to feel fear, guilt, and isolation. In addition, they may be advised by lawyers to keep silent and not to admit having erred. What they desperately wish to avoid is the nightmare of a lawsuit.

The human problems caused by medical mistakes are thus complicated and require careful handling. This fact underlies the importance of apologies on the part of doctors who have erred in their practice.

At firsthand, I know the benefits of having a physician apologize. A doctor once apologized to me for a mistaken diagnosis. She, a relatively inexperienced internist, missed recognizing my ailment as a case of shingles.

Almost immediately on seeing me, a veteran nurse practitioner diagnosed it properly and I received treatment. In this instance, the physician’s mistake caused me no harm, but her apology was welcome to me and, I presume, relieved her own feelings of embarrassment and, perhaps, guilt.

For a longtime dear friend, whom I will call Sylvia, the stakes were much higher. Sylvia has shared with me the story of what she calls “a huge mistake” made by her surgeon at a Boston hospital more than a dozen years ago.

In the course of doing a hysterectomy, that woman doctor punctured Sylvia’s bladder. The complications that resulted from this error caused Sylvia much pain and suffering. The whole experience was a terrible ordeal for her, and took a long time to be resolved.

The only thing that made this medical experience at all tolerable for Sylvia was that her doctors later apologized to her for their mistakes. Both the surgeon and the resident who assisted her took responsibility for the errors and said they were sorry.

Speaking of the surgeon, Sylvia says: “Her apology made all the difference in the world to me.” She adds that without the apology, “the recovery would have been more difficult.”

Several times, friends had urged Sylvia to sue the doctors. They argued that “doctors get away with this all the time.”

But Sylvia refused to resort to a lawsuit. “I did not feel any vengeance,” she says; and she holds to the view that people make mistakes. The apology offered more comfort to her than any legal action could ever have done.

Another of my close friends, (let’s call him Robert), suffered long neglect from the specialist whom he was supposed to see regularly. Though Robert’s health was clearly in decline, this doctor never did see him personally but left consultations to his assistants. Only when another friend, himself a physician, intervened, did Robert get hospitalized for the care that he urgently needed.

When he finally got a diagnosis, it became clear that Robert was in grave danger of a health catastrophe. Ultimately, the need for replacement of a heart valve was diagnosed, for which my friend had to undergo three surgeries.

For none of the surgeries did Robert feel that the risks and outcomes were adequately explained to him. He felt resentment at what he considered neglect.

When the whole ordeal was over, Robert did receive an apology. But it came, not from any of his doctors, but rather from a nurse practitioner. That did not atone for the neglect he had encountered from his primary care physician, whose neglect put his life in danger, and from the surgeon who took precious little account of his patient’s feelings.

For a time, the primary care physician was planning a professional discussion session in which he was going to include Robert. Somehow, though, he backed down and my friend never heard anything more about it.

Richard Griffin