Saving the Important Work of Second Victim Support Programs

Will the success of the “second victim” assistance movement, propelled by Dr. Albert Wu’s 2000 seminal article (; PMID # 10720336), with its strong emphasis on the use of trained volunteer peers, fall prey to plaintiff lawyers’ attempts to pierce these therapeutic encounters in search of possible admissions of liability?

A recent article appearing in the Journal of Law, Medicine and Ethics (; PMID # 24446943) sounds the alarm. M. de Wit and her colleagues point out that currently no federal law protects exchanges between second victims and those who provide them with emotional support in the immediate or longer-term aftermath of an adverse event.  Their evaluation of statutory privileges in five states (because state courts are the likely venue for any malpractice action) fails to produce an unambiguous pathway for protection among any of the statutory schemes.  Despite this, they point to data showing how effective three tiers of interventions have been in reducing symptoms and their residual impact on affected clinicians.

“In one survey, 69% of Second Victims reported that they reached out for support following an adverse event, and more than half received support from someone in the health system in which the event occurred. When asked to identify which supportive strategies would be most useful to them, the most frequent answers were ‘debriefing, crisis intervention, stress management, and an opportunity to discuss any ethical concerns you had to the event or the processes that were followed subsequently.’ These strategies go to the very heart of what nascent Second Victim programs are attempting to offer health care providers involved in adverse events.” (; PMID # 21532531)

The authors call upon state legislatures to “revisit and recodify the concept of ‘physician-patient privilege,’” as well as amending federal legislation such as the Patient Safety and Quality Improvement Act of 2005, in order to clearly bring within the ambit of existing protections interactions between “Second Victims” and the volunteers and health care workers who render psychological first aid to them. The authors close appropriately with the following observation: “It would be ironic if those who provide us care when we must access the health system did not enjoy the same security we do in seeking aid when they need it most.”

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