Joint replacements are the #1 expenditure of Medicare. The process of approving these medical devices is flawed according to the Institute of Medicine. It is time for patients' voices to be heard as stakeholders and for public support for increased medical device industry accountability and heightened protections for patients. Post-market registry. Product warranty. Patient/consumer stakeholder equity. Rescind industry pre-emptions/entitlements. All clinical trials must report all data.
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Wednesday, April 3, 2013

Guilty doctor, angry patient: apology asymmetry.

by SHANKAR VEDANTAM     NPR Morning Edition
April 01, 2013 3:16 AM
To err is human.
So is refusing to apologize for those errors.

From toddlers and talk show hosts to pre-teens and presidents, we all know people who have done stupid, silly and evil things then square their jaw and tell the world they've done nothing wrong.
Parents, educators and even public relations flacks have talked at length about the value of coming clean, and there is abundant research on the psychological value of apologizing. But psychologists recently decided to take a new tack: If so many people don't like to do it, there must be psychological value in not apologizing, too.
In a recent paper, researchers Tyler G. Okimoto, Michael Wenzel and Kyli Hedrick reported on what they've found happens in people's minds when they refuse to apologize. They find that parents who tell their kids that saying sorry will make them feel better have been telling the kids the truth — but not the whole truth.
"We do find that apologies do make apologizers feel better, but the interesting thing is that refusals to apologize also make people feel better and, in fact, in some cases it makes them feel better than an apology would have," Okimoto said in an interview.
Okimoto surveyed 228 Americans and asked them to remember a time they had done something wrong. Most people remembered relatively trivial offenses, but some remembered serious offenses, including crimes such as theft.
The researchers then asked the people whether they had apologized or made a decision not to apologize, even though they knew they were in the wrong. And they also divided the people at random and asked some to compose an email where they apologized for their actions, or compose an email refusing to apologize.
In both cases, Okimoto said, refusing to apologize provided psychological benefits — which explain why people are so often reluctant to apologize.
The same thing happened when people were asked to imagine doing something wrong, and then imagine apologizing or refusing to apologize.

"When you refuse to apologize, it actually makes you feel more empowered," he said. "That power and control seems to translate into greater feelings of self-worth."
Ironically, Okimoto said, people who refused to apologize ended up with boosted feelings of integrity.
The researchers are not suggesting that refusing to apologize is a useful life strategy: Okimoto himself said he has little trouble apologizing. The interpersonal benefits of apologizing are huge, and an apology can not only renew bonds between people, but between countries.
Okimoto believes the research, in fact, may provide a clue on how best to get people to apologize. Our conventional approach, especially with kids, is to force people to apologize. But if people are reluctant to apologize because apologies make them feel threatened, coercion is unlikely to help – that is, if a sincere apology is hoped for.
Support and love, by contrast, may be a more effective way to counter the feelings of threat involved in an apology.
The next time junior — or your partner — does something wrong, pass on the stare and try a hug.
Volume 49, Issue 3, May 2013, Pages 315–324

The apology mismatch: Asymmetries between victim's need for apologies and perpetrator's willingness to apologize
         Joost M. Leunissena, , , David De Cremerb, Christopher P. Reinders Folmerc, Marius van Dijkea
            a Rotterdam School of Management, Erasmus University Rotterdam, The Netherlands
            b China Europe International Business School, Hongfeng Road, Pudong, China
            c Ghent University, Gent, Belgium

Guilt and anger (among perpetrators and victims) explain the asymmetries we see in apologies. #PW
3/27/13 12:02 PM

Although previous research on apologies has shown that apologies can have many beneficial effects on victims' responses, the dyadic nature of the apology process has largely been ignored. As a consequence, very little is known about the congruence between perpetrators' willingness to apologize and victims' willingness to receive an apology. In three experimental studies we showed that victims mainly want to receive an apology after an intentional transgression, whereas perpetrators want to offer an apology particularly after an unintentional transgression. As expected, these divergent apologetic needs among victims and perpetrators were mediated by unique emotions: guilt among perpetrators and anger among victims. These results suggest that an apology serves very different goals among victims and perpetrators, thus pointing at an apology mismatch.

► The present paper investigated the congruity between victims' and perpetrators' need for apologies ► A mismatch between victims' and perpetrators' need for apologies is observed ► This mismatch is driven by the intentionality of the transgression ► This effect was mediated by anger (victims) and guilt (perpetrators) ► This mismatch has consequences for actual apology behavior and subsequent forgiveness

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