Research probes ‘institutional betrayal’

MEDICAL ERRORS

The bare physical facts of Brittany Bowley’s childbirth were harrowing enough.

Her son’s head had emerged when suddenly the rest of his body got stuck, prompting a dramatic effort to literally “cork-screw” the newborn out and allow him to start breathing.

But it was the way nurses and doctors responded to the crisis six months ago that left Bowley soured by the experience.

The Airdrie, Alta., woman with a tiny physique says no one checked for potential complications during her 41 hours of labour; the delivering doctor suggested she get counselling for post-traumatic stress, but none was offered; and a pediatrician called the baby’s broken arm a minor problem that would clear up in seven to 10 days.

It still had not healed a month later, the limb having stopped moving by then.

“They shrugged off the whole experience, basically,” Bowley says. “The whole situation makes me angry.”

Her son has fully recovered. But lingering feelings of neglect such as Bowley’s are the focus of fascinating new research that adds a novel twist to discussion of medical error and patient safety.

Psychologists at the University of Regina are scrutinizing the health-care system for signs of what they call “institutional betrayal”: a failure of organizations to respond effectively to unexpected or negative events, potentially causing unnecessary emotional trouble for patients.

The concept was conceived just eight years ago by University of Oregon researchers, initially to describe the reaction of rape victims to colleges or religions organizations that gave short shrift to their allegations.

Early work by the Saskatchewan academics suggests that for patients, feeling betrayed by a trusted health-care institution sometimes produces or aggravates post-traumatic stress syndrome, depression and anxiety.