What is it like to cause a road accident or make a medical error as a doctor? Femke Ruitenbeek (Erasmus School of Law) researched this in her PhD thesis. Her research shows that perpetrators do not always meet with victims. Ruitenbeek: “This gets in the way of recognition and apologies from the perpetrator and hampers the healing process for those involved.”
An everyday drive to school or work can end dramatically. Every year, an average of over 600 people are killed in traffic, and many more suffer injuries in collisions. An accident has a significant impact on victims and those close to them. But what is it like for the person that caused it? What is the aftermath like for them, and do they feel the need to contact the victim, for instance to apologise? According to Femke Ruitenbeek, there is hardly any focus on that. To gain insight into this, the PhD student interviewed people who have caused road accidents and doctors involved in medical errors. She also spoke to personal injury lawyers involved in the settlement of traffic accidents and alleged medical errors.
Little attention for personal interests
Ruitenbeek worked in the legal profession for many years, and also handled personal injury cases. What struck her in this is that the question of liability (and compensation) predominates. Consequently, such cases often remain acrimonious. The victim will mainly have to deal with an insurer’s lawyer, and the perpetrator is usually completely sidelined. “This gets in the way of recognition and apologies from the perpetrator, and hampers the healing process for those involved. Fortunately, you can see that the focus on personal interests has increased in recent years,” the researcher observes.
Sympathy naturally goes out to the victim, and so you can see that the main focus is on their interests. In the media you often read about road rage and cases of reckless driving. But in many cases there was no intent, and the perpetrator may also be deeply affected by the accident. For example, Ruitenbeek spoke to a man who noticed a traffic jam too late because he was distracted. He crashed at high speed into a stationary car with a mother and her young son. The toddler was in the back seat and died in the accident. The perpetrator was never able to get in touch with the family of the little boy who was killed, and therefore could not apologise. He still found that very difficult years later.
Contact is uncommon
Many of the perpetrators the researcher spoke to wish to meet the victims. But to make contact, they are dependent on parties such as the insurance company or the police. They don’t always get in touch with the victim, Ruitenbeek observes: “They experience this as frustrating and tough, because they would like to know how the other person is doing. The accident can take a heavy toll. Some people were unable to work for a while, or worked less. There were also people who developed symptoms of depression, and sometimes even suicidal thoughts.”
Apologies are not an admission of guilt
Doctors who are sued for medical malpractice can also suffer badly. Doctors want to do right by their patients and take an oath to do so. Still, surgeries can go wrong or a diagnosis can be made too late. “Doctors often still think that they should not apologise because that would be tantamount to an admission of guilt. If you look at the law, it is much more nuanced. Doctors have far more freedom in what they can say than they think. Yet I felt that doctors were not always sure what they can and cannot say. They are afraid of the possible consequences of their words.”
But doctors sometimes also felt powerless, for example when they felt that claims were unfair. They then doubt whether a mistake was made at all, but feel that they are not able to have their say. Yet at the same time, doctors are also hesitant, because they don’t want to make the patient feel that they should share their story with them. “Patients don’t always consider the impact of a claim on doctors,” says Ruitenbeek. “Moreover, patients have become much more outspoken. If claims are brought too quickly, there is a chance that fear of reputational damage will result in doctors ordering additional tests for other patients in the future. Given the long waiting times and rising costs, this would not help the healthcare system.”
Make contact easier
Ruitenbeek argues that contact between perpetrator (doctor or road user) and victim (patient or traffic victim) should be encouraged more. The medical sector already pays a great deal of attention to this, but the question is whether it gives enough attention to the personal story of the health professional. For violent crimes, there is a foundation that mediates in contacts between victims and perpetrators. This foundation also mediates in serious traffic cases. “They are very good at what they do. Mediators contact the parties to find out if they each feel the same need for contact, which is very important. When expectations are too far apart, such a mediation attempt can actually be counter-productive. But when it’s guided properly, contact can help both parties in the coping process.”
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Promotion
Femke Ruitenbeek will defend her PhD thesis ‘And what about the perpetrator? An empirical legal study into the position of the perpetrator in civil personal injury practice’ on Friday, 26 May.
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- Related links
- Wat te doen als je iemand een rolstoel in hebt gereden? (interview in Dutch in newspaper NRC)
Listen to Femke Ruitenbeek in dr. Kelder en co. (in Dutch)
