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The Second Victim: A Contested Term?

Journal of Patient Safety 2018 December 19
OBJECTIVES: The term "second victim" was seminally coined by Wu, in recognition of the profound and long-lasting impact adverse events and medical errors may have on medical practitioners. Since the conception of this vocable over a decade ago, the term second victim has been internationally accepted and is widely used in discussion of this important topic. Notwithstanding its widespread use, controversy surrounds the term second victim in light of the traditional connotations with the word "victim." However, notable in their absence are the views of medical practitioners on the use of this term. This article addresses this gap through an exploration of perceptions on the terminology used to describe physicians who experience distress after an adverse event or medical error.

METHODS: This research arose as part of a wider study on the dynamic of medical negligence litigation in Ireland. The study used a qualitative approach, using semistructured interviews as the data gathering instrument. The sample involved representatives of medical training bodies (2 individual interviews and 1 focus group of 4 individuals) and legal professionals (barristers) (12 individual interviews). Those interviewed from medical training bodies were physicians who have an active role in the college providing training and support to their members.

RESULTS: A number of participants shared their views on the term second victim, and the findings of this study suggest that some physicians and legal professionals are uncomfortable with the term second victim despite its widespread use in other jurisdictions. This is due to the traditional connotations that surround the term victim, and the perception that being labeled a victim may undermine the harm experienced by the patient.

CONCLUSIONS: Although the impact of adverse events and medical error on the physician is undisputed, use of the term second victim can be seen as insensitive to the patient, as well as dissipating the professional identity of the healthcare provider. Second victim is an internationally recognized term, as coined by Wu (2000). Finding an appropriate replacement is an important but difficult task.

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