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Medical Errors And Medical Narcissism / Edition 1
     

Medical Errors And Medical Narcissism / Edition 1

by John Banja
 

ISBN-10: 0763783617

ISBN-13: 9780763783617

Pub. Date: 12/13/2004

Publisher: Jones & Bartlett Learning

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

Overview

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.

Product Details

ISBN-13:
9780763783617
Publisher:
Jones & Bartlett Learning
Publication date:
12/13/2004
Edition description:
1E
Pages:
229
Product dimensions:
6.00(w) x 9.28(h) x 0.69(d)

Table of Contents

Dedicationvii
Prefaceix
Chapter 1Error1
Introduction1
To Err Is Human1
Defining Medical Error: Prominent But Poor Definitions4
Defining Medical Error: A Better Definition5
Performance Failures7
Error Inevitability8
The Systemic Nature of Medical Error9
Systemic Defenses or the Lack Thereof11
An Absence of System Checks12
Applications to Disclosing Error13
Conclusion15
Chapter 2Rationalization19
Introduction19
The Emotional Response to Medical Error19
What Professionals Are Advised About Communicating Error21
How Do Professionals Actually Communicate Error?26
Rationalizing the Concealment of Medical Error: Two Explanatory Models30
How to Rationalize33
Application of the Selective Attention Model to Concealing Medical Error37
Conclusion: Is Rationalization Conscious or Not?40
Chapter 3Narcissism47
Introduction47
Healthy and Pathological Narcissism49
The "Medical Narcissist"55
Making the Narcissist61
Three Characteristics of Medical Narcissists and Their Applications to Medical Error68
Conclusion79
Chapter 4Scram: A Case Study87
Introduction87
The Case88
Minimization/Maximization96
Medical Narcissism99
A Final Point on Systemic Error100
Chapter 5Forgiveness103
Introduction103
The Significance of Forgiveness109
Narcissistic Barriers to Requesting or Bestowing Forgiveness111
The Trajectory of Forgiveness113
Justice and Forgiveness115
Conclusion116
Chapter 6Remedies119
Introduction119
Section 1Tort Reform120
The Malpractice Crisis120
Enterprise Liability and Medical Error Disclosure125
No-Fault128
Two No-Fault Systems129
No-Fault and Errors130
Section 2The Blameless and Nonpunitive Environment132
Introduction132
Understanding and Assessing Responsibility134
Blame136
Blaming: Some Preliminary Considerations137
Errors and Process Violations140
Assessing the Degree of Blamability for Process Violations143
Reckless Errors144
Ex Ante Versus Post Hoc Perspectives on Error Evaluation147
Evaluating the Error Evaluators148
Blameless and Nonpunitive Environments and the Disclosure of Error149
Section 3Mindfulness150
"Teaching" Ethics150
Other Regard/Empathy Revisited152
Managing Resistance to Error Disclosure162
Managing Rationalizations of Error163
Conclusion164
Chapter 7The Empathic Disclosure of Medical Error173
Introduction173
Part IThe Empathic Model174
Part IIHow to Disclose179
Initial Considerations179
Talking and Listening181
Conclusion186
Chapter 8Beyond Errors-Beyond Narcissism193
The Narcissistically Cohesive Self194
Longings196
The Healer197
Errors and Humility200
The Narcissus202
Appendix 1Error Rationalization and the Somatically Marking Brain205
Introduction205
Emotional Ethics205
Rationalizations as Salienced Representations208
Limitations of the SMH for the Explanation of Moral Rationalization211
Appendix 2Becoming a Narcissist215
Introduction215
The Myth of Narcissus215
A Healthy Regard for Otherness217
The Pathological Narcissist218
The Sadomasochistic Narcissist221
Conclusion221
Index225

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