UNDERSTANDING APOLOGY: MECHANISMS FOR REPAIRING RELATIONSHIPS

June 27 30, 2010

Aaron Lazare, M.D.
Professor of Psychiatry
Celia and Isaac Haidak Professor of Medical Education
Chancellor and Dean Emeritus
University of Massachusetts Medical School
Worcester, MA

The offering and accepting of apologies is one of the most profound human interactions. For the
offended party, an apology can heal a humiliation and a grudge, remove the desire for vengeance
that can grip the mind with persistence and tenacity, and generate forgiveness. For the offender,
an apology can relieve guilt and shame and diminish the fear of retaliation. The result of the
apology process, ideally, is the reconciliation and restoration of broken relationships but not
without risk.

Definition and Semantics of Apology

An apology is an acknowledgement of responsibility for a wrongdoing (or an offense) followed
by expressions of remorse, forbearance, and reparation (when appropriate). Two parties are
involved, one who commits the offense and the other who is the offended party. The two parties
may consist of two individuals, one individual and another larger body (such as a business, an
institution, or a nation), or two large bodies. Within heterogeneous bodies, several agendas may
be involved. The essence of this definition of apology dates back to the 17th century.
The wrongdoing or offense in medical practice refers to an untoward treatment outcome that
should have been avoided according to ordinary or community medical standards.
An Earlier and Continuing Definition of Apology
An earlier definition of apology, still in use, derives from the Greek word apologia meaning
justification, excuse, or explanation. The United States Presidents press secretary, for example,
often functions as an apologist, a person who explains and justifies the Presidents speeches and
writings. This is an entirely different meaning from the more common definition of apology as
an admission of wrongdoing, regret and repair.
Does I am sorry constitute an apology?
I am sorry may be a compassionate expression which someone may verbalize in response to
hearing anothers bad news such as sickness or a death in the family. In this sense, it is not an
apology because there is not any wrongdoing. I am sorry is an apology when the offense is
explicit such as I am sorry for not inviting you to the celebration or clearly implied as when
someone bumps into another and says I am sorry.

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Is I Apologize always an apology?

The two words I apologize offered following an offense, absent a clear acknowledgement of
the offense, an explanation, or remorse, does not meet the definition of an apology.
I apologize is inappropriately used when there is an understandable inconvenience but no
offense. An example is a sign at a construction site we apologize for the inconvenience or a
sign at a parking garage we apologize - the lot is filled. In both situations, there is no offense.
The word regret would be more appropriate.
What does it mean to demand an apology?
The expression I demand an apology is commonly used to humiliate the other party and put
him/her on the defensive, not to heal an offense.
The casual sorry, excuse me, or pardon me.
These casual expressions are common responses to minor offenses such as inadvertently
blocking anothers way, bumping into anothers shopping cart, or inadvertently cutting in front
of someone in line. These expressions are meant to convey that there was no purposeful or
aggressive intent. Absent these apologetic expressions, the recipient interprets the block, the
bump or being cut off as an offense, a deliberate insensitive action.
Are There Non-Verbal Apologies?
Physical gestures can be understood as non-verbal apologies. Examples include German
Chancellor Willie Brandts kneeling at the Warsaw Ghetto Memorial, and Pope John Paul 23rd
praying at the Western Wall in Jerusalem.

The History of Apologies

Apologies can be traced to preliterate humans who apologized not only person to person and
tribe to tribe, but human to animal.
One of several apologies in classical Greek literature (the Iliad, 600 BCE) involves Agamemnon,
a military general, who apologized to his subordinate, Achilles, in hopes that the latter would
relinquish a grudge and resume his role as military leader. The apology failed. Achilles refused
to fight.
Apology is a key part of repentance in the five great world religions: Hinduism, Buddhism,
Judaism, Christianity, and Islam. (The Talmud says that G-d created 7 things before creating the
universe. One of the seven was repentance.) In the three Abrahamic religions, the word for
repentance, translated into English, is turning away from sin and turning to G-d.
Apology has long been a part of legal systems. It is generally thought that a defendant accepting
responsibility and expressing remorse for criminal actions can be a mitigating factor in
sentencing.
Primates have been observed to make non-verbal apologies following aggressive behaviors.

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A Measurement of the Increasing Frequency of Apologies

It can be shown, measuring the use of the word apology in newspapers, that the frequency of
apologies in the United States has rapidly increased beginning in the early 1980s.
Number of Apology Articles
Washington Post & New York Times
1900-2010
(five year intervals)
Number of Articles

700
600
500

WaPo
NYT

400
300
200
100

20
10

20
08

20
06

20
00

19
90

19
80

19
70

19
60

19
50

19
40

19
30

19
20

19
10

19
00

Years

The Growing Importance of Apologies

There are several explanations for the growing interest in apologies:

An increase in world population (2 billion in 1950 to nearly 7 billion in 2010).

The end of World War II and the Cold War
Empowerment of previously disenfranchised populations: e.g., Native Americans,
African Americans, women, LGBT, Aborigines, Japanese Americans
Influence of Pope John XXIII and Pope Paul II
The Millennium and the Jubilee Year
The world as a global village: satellite, internet, cable TV, cell phone, e-mail,
international finance, climate change

Current Interest in the Apology Process

The following groups and organizations have demonstrated an emerging interest in apology
during the past decade:
Business and Law Schools, Legal organizations
Medical Schools, Nursing Schools, Hospitals
Colleges and Universities (departments of social psychology, sociology, ethics, religion,
gerontology)

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Houses of Worship Hindu, Buddhist, Jewish, Islam, Unitarian, Christian (Roman

Catholic, Greek Orthodox, Protestant)
Mediators: (lawyers, couples therapists, social workers, international peace
organizations)
Psychotherapists
Substance Abuse/Addiction treatment professionals (12 step programs)
Retirees
Assisted Living Groups
Hospice Care Organizations
Industry
Law Enforcement Agencies (Attorney Generals Office, Police Academy)
Media: Psychology Today, Talk of the Nation, ESPN, BBC, CBS, Washington Post, the
Forward, Commonweal Magazine, On Faith, Oprah and other.

The History of Apologizing in Medical Practice

It has been common practice in medicine not to apologize for committing mistakes. The recent
importance of apologies in medical practice has been stimulated by the Institute of Medicines
1999 publication of To Err is Human and JCAHOs 2001 requirement that hospitals inform
patients of medical errors. It is widely believed at this time that apologizing to patients is not
only humane but diminishes malpractice suits.

How Apologies Heal: The Needs of the Offended Party

Despite the increasing frequency of public and private apologies and a growing body of literature
on the application of apologies, there is a paucity of literature on the apology process itself,
particularly the psychological needs of the offended party and how an effective apology meets
these needs.
I propose a more comprehensive analysis of the psychological needs of offended parties, an
analysis which has common sense appeal, is applied intuitively by effective interviewers, and
can be validated by quantitative studies of offended parties who want or have received apologies.
I name the traditional perspective of the apology process The Healing Mechanisms of the
Apology and add two additional perspectives on the needs of offended parties that are crucial to
the success of the apology: The Goals and The Framework(s). Failure in any one of these three
domains can render the apology ineffective or even counterproductive.
Healing Mechanisms of the Apology
Five items which fall under the category of content have been traditionally regarded as the core
of the apology process:
The offender must acknowledge or validate the offense with a clear description of the
harm done including the nature of suffering of the offended party, an acknowledgment
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that the offended party was not at fault, and an acknowledgment between the two
parties of shared values, what is right and wrong. The issues of fault and values when
implicit and obvious to both parties may not need discussion.
The offender must explain why the offense occurred.
The offender must offer an expression of remorse, that he/she deeply regrets what has
happened.
The offender pledges the offense will not recur.
The offender and/or institution must offer reparation for damages, be it verbal, financial
or otherwise.
Goals of the Apology

There are five interrelated goals or outcomes of the apology process:

A desire for dignity and power to be restored in contrast to being disrespected,
humiliated or disempowered. The offended party may experience humiliation or
disrespect when they believe the offender is withholding important information, lies to
them, speaks in a condescending manner, fails to listen attentively, seems in a hurry to
leave, or avoids meeting with them. Offended parties report feeling respected, and
their dignity restored, by the demeanor of the offender, and feeling empowered when
their misfortune leads to positive changes in procedures.
Wanting to feel cared for, that they are more than a problem that needs to be solved.
A desire to to forgive the offender in the sense of letting go of the hostile feelings and
ruminations that consume their everyday thinking.
Following an untoward incident, the offended party wants an apology which they
perceive as sincere and genuine, that the offender can be trusted to make things right.
A desire to feel that the offender is empathic, that he or she understands how the offended
party feels.
The above five goals are not commonly thought of as integral to the apology process because
they are the intangibles of all human interactions. Without such goals being achieved, however,
apologies are likely to fail.
Framework(s) of the Apology
Framework(s) describes who is present for the apology discussion, where the apology takes
place, when the apology takes place, and the rules of emotional interaction.

Determine who should be present for the apology discussion. The offended party and the
offender, or their representatives, are the principals. Depending on the situation and
institutional policies, an administrator or other personnel may need to be present.

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Setting of the discussion. A setting that affords privacy, comfortable amenities, and
adequate time is preferable. Cell phones and other devices should be turned off;
distractions and interruptions avoided.

Timing of the apology. Formal and complete apologies should be withheld until the
presence of and the nature of the offense or mistake is clear. A generally overlooked
but important aspect of timing is the suggestion by the offender for him/her to return for
one or more meetings with the offended party to listen to concerns that have not
previously been verbalized. This is recommended on the premise that following a
traumatic event which warrants an apology, the offended party, hours or days after the
initial discussion, will likely become aware of previously overlooked issues they now
wish to discuss.

Importance of the offended party having the opportunity for catharsis, verbalizing their
feelings about the event and the offender. Absent such expressions of feelings, the
offended party will feel the communication is unsatisfactory and incomplete.

The importance of a dialogue. Often, the offender speaks rapidly, in a monologue, and
avoids interruption. The offended party will be dissatisfied if unable to speak and
observe the offenders response. The offended party will have concerns, worries,
questions, and feelings that, if unexpressed, can mask their distress and deprive the
offender of an understanding of the offended partys needs. A dialogue allows the
offender and the offended party to react to and develop a relationship with each other.

An Integration of Healing Forces

The above compendium of healing forces in apologies may seem mechanical or unnecessarily
cumbersome. They are, in fact, rarely applied in totality in any given apology. In practice, each
apology has its own unique healing requirements for effectiveness. It is the skill of the person
offering the apology, by listening and observing, to successfully recognize and address the
cognitive and emotional needs of the offended party.
In delivering an apology, a failure in any one of the three , by itself, can be enough to undermine
the effectiveness of the apology, for example:
If the offended party does not feel the offender is being genuine, sincere, caring, and
respectful, it will be very difficult for the other healing mechanisms to overcome the ill
will that is generated.
Of the healing mechanism issues in the apology process, the offender should be most
concerned with properly acknowledging and taking responsibility for the offense.
Often, an offender is so uneasy about admitting an offense (a mistake) that he/she offers
a half-hearted acknowledgement and conditional statement such as if I caused any
trouble, or delivers in the passive voice: mistakes were made; or offers I am sorry
without acknowledging responsibility.
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 Failure of any one of the framework issues, the timing, the principals, the setting, or the
catharsis/dialogue could compromise the effectiveness of the apology. The discussion
will not be productive and the goals of the apology will not be met.
Learning to Apologize
A metaphor for learning to offer an effective apology is learning to play a musical instrument,
such as the piano. We can learn to identify the notes on the keyboard and read music, and we
can practice various exercises. This is only the beginning. Motor skills, rhythm, interpretation,
and numerous intangibles, some learned and others inherited, are necessary to become a fine
musician.
In learning to offer effective apologies, we can be trained to address the goals, framework and
content of the apology, all the time recognizing that each apology will be unique. An effective
training model would give us the opportunity to understand, practice and master each individual
skill. Just as music students hone their skills by practicing scales and other exercises, so it is
hoped we will be able to apologize effectively by understanding the three sets of healing
mechanisms and acquiring experience by training and practice.
This analysis provides a guide for educating and training for delivering effective apologies.
Table One: A Comprehensive Outline to Healing Mechanisms in Apologies
Framework(s)

Goals

Healing Mechanisms

Restoring dignity/power

Principals

Feeling cared for

Setting

Experience of empathy

Timing

Restoring sincerity/trust

Catharsis

Remorse

Ability to forgive

Dialogue

Explanation

Reparation

Pledge for future

Motives to Apologize
Empathic Apologies

Diminish personal shame

Diminish personal guilt

Strategic Apologies

Avoid punishment

Placate other party

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Acknowledgment
(Validation, fault, suffering,
shared values)

Resistance to Apologizing

Shame over admitting fault

Negative reactions of the other party
Fear of reparation including legal vulnerability
Some people do not know how to apologize
Apologizing gives someone the god-like power to forgive you
She might never want to see me again.
My professor might publicly humiliate me in front of the class.
It makes me feel weak to apologize.
I might show hidden inner emotions like sadness or anger and start to cry. I might then be
perceived as weak.
When you apologize, you let your guard down and you are like a soldier going into battle
without armor or a gun.

The Timing of Apologies

Apologies Offered Too Soon

The offended party might not understand the nature of the impact of the offense

Apologies Delayed

A new awareness of the apology process

A growing sense of unbearable guilt
Advice of AA or religious organization
New perspective on life: aging, illness
Public exposure of the offense
Creating self-serving opportunities
Emerging ethical ideals
Offense is discovered
Delayed reaction by the offended party

Public vs. Private Apologies

Sincerity less important

Less spontaneous
Details for the record
Difficulty determining precisely the offender and the offended
The offense may have been caused by a predecessor (genocide, slavery)

The Role of Apologies in Mediation

In conflict and/or mediation over tangible issues involving money, real estate, etc. it is worth
considering whether the fundamental issue is shame, embarrassment, and/or humiliation. Words
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in every day conversation indicating these emotions include: hurt (feelings), taken aback,
offended, disrespected, treated insensitively, treated without dignity, betrayed,
wounded, violated, humiliated, unappreciated. The presence of these emotions should
alert the mediator or one of the adversaries that an apology properly delivered may be the most
effective action needed to resolve the conflict. Sometime an independent party, not the
adversarial pair, will be needed to resolve the conflict by offering the apology or advising one of
the adversaries to apologize.

The Implications of Apology

Apologies are important but commonly overlooked healing forces between individuals, groups
and nations. The frequency and importance of apology in national and international affairs has
increased exponentially since 1980 (see graph). There is good reason to believe that apologies
between individuals parallel those that make the news headlines. The majority of the literature,
books and journal articles on the subject have appeared during the past decade. Unfortunately,
most apologies, at least those that are public, are counterfeit; that is, they try to gain something of
value from something that is falsely constructed and cheap. There is a great deal to be gained,
both morally and substantively, by making genuine apologies.

Conclusions
An apology is an act of honesty
An apology is an act of generosity
An apology is an act of humility
An apology is an act of commitment
An apology is an act of courage

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References
Lazare A: On Apology. New York: Oxford University Press, 2004.
Lazare A: Apology in Medical Practice: An Emerging Clinical Skill. JAMA, Vol. 296, No. 11, 1401-1404,
September 20, 2006.
Lazare, A. You Call That an Apology? The Washington Post, Sunday, July 3, 2005.
http://www.washingtonpost.com/wp-dyn/content/article/2005/07/02/AR2005070200060.html
Lazare, A. What Imus Should Have Said, and Why. On Faith Guest Voice, The Washington Post, April
17, 2007.
http://newsweek.washingtonpost.com/onfaith/guestvoices/2007/04/what_imus_should_have_said_and.html
Lazare, A. Apology as a Moral Imperative. On Faith Guest Voice, The Washington Post,
September 21, 2007.
http://newsweek.washingtonpost.com/onfaith/guestvoices/2007/09/apology_as_a_moral_imperative.html
Lazare, A. How Apologies Heal. On Faith Guest Voice, The Washington Post, November 16,
2007. http://newsweek.washingtonpost.com/onfaith/guestvoices/2007/11/how_apologies_heal.html
Lazare A: The Healing Forces of Apology in Medical Practice and Beyond. DePaul Law Review 2008,
Vol. 57, No. 2, 251-265.
Lazare, A. Analyzing the Popes Apologies. On Faith Guest Voice, The Washington Post,
April 14, 2009.
http://newsweek.washingtonpost.com/onfaith/guestvoices/2009/04/analyzing_the_popes_apologies.html
Lazare, A. An Ineffective and Insincere Apology From Tiger Woods, The Washington Post, February
21, 2010.
http://newsweek.washingtonpost.com/onfaith/guestvoices/2010/02/an_ineffective_and_insincere_apolog
y_from_tiger_woods.html
Lazare A: The Apology Dynamic. AAOS Now, Volume 4, Number 5, 2010

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10

INSTITUTIONAL APOLOGIES: WHEN, WHY, AND HOW TO APOLOGIZE TO THE

AGGRIEVED, THE CAMPUS, AND THE PUBLIC
June 27 - 30, 2010
Miles J. Postema
Vice President and General Counsel
Ferris State University

I. INCREASE IN PUBLIC APOLOGIES.

There can be little dispute that institutional apologies have become more prominent
since the 1990s; and, many are made publicly. Much of the literature concerns
medical errors or mistakes, but increasingly public apologies involve other matters as
well, including: professional athletes, celebrities, corporations, and other businesses.
Universities are not immune from making mistakes and because of the nature of
university and college campuses mistakes are bound to occur on a relatively regular
basis. Universities are large and complex entities performing numerous functions on
and off-campus and generally include many acres of real estate, residential housing,
large dining operations, recreational facilities including recreation centers, golf
courses, swimming pools, and other facilities. University and colleges often have
extensive auxiliary enterprises, including: hotels, conference centers, restaurants, and
coffee shops. Many campuses have their own deputized police force or public safety
offices. In short, colleges and universities are extraordinarily complex entities.
The following is a short list of incidents or mistakes made on university campuses:
A. University apologizes for planning of Kyi-Yo celebration.
http://news.umt.edu/2010/04/042010powo.aspx
B. University apologizes for offensive cartoon.
http://wsbt.com/news/local/81818137.html
C. University apologizes for banning girl with Downs Syndrom from barbecue.
http://www.thisisnorthdevon.com.uk/news/Petroc-apologises-barbecue-ban/article1568465
D. University apologizes for fan behavior.
http://statejournal.com/story.cfm?storyid=74693&func=viewstory
E. Washington University issues expression of regret for faculty e-mail.
http://mednews.wustl.edu/web/page/normal/8195.html,
http://crossman.motime.com/post/617479/Not+all+doctors+approve+of+Amendment
+2
F. President Summers apologizes for comments at conference on women and science.
http://www.president.harvard.edu/speeches/summers_2005/womensci.php.
G. Duke President shares lessons learned and regrets about lacrosse case.
http://www.dukenews.duke.edu/2007/09/rhb_lawconf.html.
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H. Brandeis President apologizes for universitys handling of museum issue.

http://www.boston.com/ae/theater_arts/exhibitionist/2009/02/brandeis_presid.html.
I. Bethel President apologizes for skit where student used black paint on his face.
http://www.bethel.edu/news-events/news/2010/may/mr-bu-statement.
J. Florida State president apologizes for remarks regarding smaller schools.
http://www.wctv.tv/home/headlines/41530202.html. (PDF of letter attached to
article.)
K. Cornell apologizes for theft of computer containing personal data.
http://www.pressoffice.cornell.edu/pressoffice/statement.cfm?customel_dataPageID_
19799=25499.
L. University demolishes the wrong house. http://conflictzen.com/how-to-screw-up-anapology/,(http://chronicle.com/article/Missing-One-House/35398/
M. Board member apologizes and resigns over inappropriate remark.
http://blogs.riverfronttimes.com/dailyrft/2010/02/in_missourah_fag_is_off_the_recor
d_missouri_southern_state_university_commissioner_resigns.php
N. University apologizes for theft of patient records from vehicle.
http://www.ksl.com/?nid=148&sid=3503000
O. University apologizes to janitor criticized for reading book on Ku Klux Klan.
http://www.thefire.org/article/9518.html
P. University apologizes for admissions communications sent in error.
New York University. http://nyunews.com/2009/04/02/20/.
University of California-San Diego. http://ucsdnews.ucsd.edu/newsrel/general/0409Letter.asp.
Cornell University.
http://www.news.cornell.edu/releases/Feb03/AdmissionsStmt.html.
George Washington University. http://www.washingtonpost.com/wpdyn/content/article/2010/02/17/AR2010021704264.html.
II.

WHAT IS AN APOLOGY?

Commentators list a number of steps or components to an effective apology. Some list as few as
two steps and others as many as eleven steps. 1 The number of steps varies but most
commentators agree that an effective apology should include the following steps 2 :
A. Recognition. Recognition involves the acknowledgement that an offense has been
committed. Missing this step may suggest that the person offering the apology does
not understand he has committed an offense.
B. Responsibility. Ultimately, to make an effective apology the institution must take
responsibility for its role. No matter who is at fault or who is to blame someone must
step forward on behalf of the university and say Im sorry. Apologizing means
taking ownership. It is best if the apology does not blame others or make excuses.
1

See AARON LAZARE, ON APOLOGY (2004) (listing four steps in the apology process: (1) acknowledgement of the
offense; (2) the explanation; (3) attitudes and behaviors expressing remorse, shame, humility, and sincerity; and (4)
reparations) and NICK SMITH, I WAS WRONG: THE MEANINGS OF APOLOGIES (2008) (listing 11 steps).
2
John Kador expresses these as the five dimensions of apology. JOHN KADOR, EFFECTIVE APOLOGY, 47 (2009).
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C. Remorse or regret. An expression of remorse evidences the offenders contrition.

Most people look to verbal or nonverbal cues because it is difficult to determine when
a person is remorseful. Ultimately, an expression of remorse will include the
statements Im sorry or I apologize. The statement Im sorry does not always
evidence an apology but can be an expression of empathy (Im sorry for your loss.).
D. Restitution. Restitution or remedy is the attempt to restore the relationship to what it
was before the offense. The offer of restitution is often the best demonstration of the
offenders desire to restore or maintain the relationship. Restitution answers the
question of what is being done to correct the problem.
E. Repetition. Repetition is the promise to the offended party that the offender will not
repeat the mistake or the offense. Generally, the person making the apology must
demonstrate that the offense has resulted in a change. What is the offender doing to
ensure that the event or mistake does not happen again?
In order to be effective, every apology or expression of empathy must be sincere. An insincere
apology or expression of empathy will likely only make matters worse. The wrong apology is apt
to backfire on the apologizer. We have all witnessed apologies that are half-hearted or are not
apologies at all.
Despite our best efforts to avoid mistakes, an apology presents the university an opportunity to
connect with the injured party and demonstrate responsibility and integrity. The negative
consequences of an error or mistake can be lessened if they are followed up with a sincere
apology that accepts institutional or individual responsibility and keeps the aggrieved partys
feelings at the forefront.
III.

WHEN IS AN APOLOGY AN EXPRESSION OF EMPATHY?

An apology can be distinguished from other forms of expression in that it acknowledges

responsibility for the conduct causing the harm. An expression of empathy or sympathy is not an
admission of responsibility. A university can, and often does, make an expression of empathy or
sympathy even when or where the university has not made an mistake or wrong. Tragedies are
bound to occur on campus because of the all encompassing and complex nature of a college
campus. Often these tragedies occur through no fault of the university. It is common for a
university representative to offer an expression of empathy on behalf of the university and the
university community.

IV.

LEGISLATION REGARDING APOLOGIES.

Over the last 10 years, some 35 states have enacted statutes that offer some protection to the
expression of an apology. Some of the statutes pertain to civil litigation generally and others
apply specifically to medical errors. The statutes vary from state to state but generally encourage
health care providers to express empathy for the patients situation. Some of these statutes
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protect true apologies and others only protect expressions of empathy (Im sorry you were
hurt). Such statutes recognize while these losses involve a monetary or economic component
there is also a sense of anger or sense of loss and an economic award alone will not bring closure
to the patient or the patients family.
In the health care field, a number of institutions have institutionalized their approach to admitting
mistakes and apologizing for them. 3 The University of Michigan of Michigan Health System 4
and Veterans Affairs Medical Center in Lexington, Kentucky both have established a practice of
admitting mistakes and making apologies in the event of medical malpractice. Both have
reported that this practice has reduced the number of lawsuits and the costs of settling medical
malpractice cases after having adopted this philosophy or policy. An Im sorry policy or
practice need not preclude an assertive defense philosophy where you conclude that there has
been no fault or negligence.
Institutions adopting an Im sorry program following a bad outcome (unexpected death,
surgery or treatment does not produce expected results) generally perform an analysis to
determine whether the standard of care was met. Initially, the hospital apologizes for the event
but does not accept or spread blame. The hospital promises a thorough investigation and pledges
to keep the family in the loop. While the standard of care analysis is being performed the health
care provider stays in close contact with the patient or the patients family. If the analysis
concludes that the standard of care was not met and there were errors or negligence the health
care provider will set a meeting with the patient, his or her family, and their attorney. The health
care provider will apologize and admit fault. The health care provider will explain what
happened and fix it. The health care provider will also offer compensation for the injury.
The Im Sorry program has three main principals: (1) compensate quickly and fairly when
negligent health care causes injury; (2) defend appropriate care cases vigorously; (3) reduce
injuries in the future by learning from mistakes.
V.

MECHANICS OF THE APOLOGY.

A.

Timing of the apology.

The timing of an apology can be important. Generally, unless the injured party is not ready to
accept the apology, the best time to offer an apology is immediately after the event or soon after.
The timing of the apology should consider the injured partys needs first. An early apology may
help avoid the filing of a lawsuit, reduce legal expenses and attendant time. An early apology
might also reduce the number of issues and mitigate damages. A late or delayed apology or the
3

Kevin Sack, Doctors Say Im Sorry Before See You in Court, N.Y. TIMES, May 18, 2008, available at
http://www.nytimes.com/2008/05/18/us/18apology.html?_r=1.
4
David Mittleman, "I'm Sorry" Policy Works for University of Michigan Health System, INJURY BOARD, July 22,
2009, http://lansing.injuryboard.com/medical-malpractice/im-sorry-policy-works-for-university-of-michigan-healthsystem.aspx?googleid=267556. According to Richard Boothman, the chief risk officer for the health system with
approximately 18,000 employees , malpractice claims against the system decreased from 121 in 2001 to 106 in 2006
and 83 in 2007. The average time to process a claim decreased from approximately 20 months to approximately
eight months. He also reported that costs per claim were reduced by about half and insurance reserves decreased by
two-thirds.
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absence of an apology may ultimately increase the chances of litigation or lengthen the litigation.
It may also increase legal expenses and the likelihood of damages. However, it is not always
clear at the outset that a mistake has been made or that an apology is owed. Sometimes an
apology might be delayed because it takes time before one understands an offense has been
committed or understands the gravity of the offense. In some cases, this understanding may be
triggered by a review or an investigation of the facts and circumstances.
An apology can be made at many different points but probably has its greatest impact when
made immediately. However, an apology can be offered at any point, including, in mediation and
in settlement discussions. In short, an apology should be made as soon as practically possible
assuming the person harmed is in a position to hear it.

B.

Who should make the apology?

For institutional mistakes an apology should be made by a fairly high ranking official of the
university. The president or chancellor may be the appropriate person to apologize on behalf of
the university. In other cases involving smaller incidents or mistakes the person making the
mistake may be the appropriate person to make the apology. An apology is likely to be better
received when it comes from a senior or upper level managers.
C.

What medium should be used to apologize?

Apologies can be made in person, by telephone, or by letter. An apology can be made by e-mail,
but this is likely the least preferred method of delivering an apology. E-mail, however, may be
the best way to apologize quickly to a large number of people. In the instance of a computer
security breach a university might issue an apology by e-mail to be followed with a letter.
If possible an apology should be made face-to-face at a time and place determined by the injured
party. Face-to-face apologies may have the most powerful transformational qualities. Delivering
the apology in person indicates the offender is serious about the apology.
It is not always possible to apologize person to person for a variety of reasons. In some cases,
particularly with a university, there may be multiple injured parties spread over a large
geographic area.
D.

Apology in mediation.

We have all heard plaintiffs say that this is not about the money or that they are only filing a
lawsuit to ensure that what happened to them does not happen to others. Many of us have been
involved in situations where the injured party desires an apology from the other party. A heartfelt
apology or an expression of empathy in mediation can diffuse and lower the anger of a plaintiff.
The mediation process may prove to the best opportunity to offer an apology if one was not
offered early on.

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Depending upon your jurisdiction probably less than five to ten percent of all lawsuits filed result
in a trial. Most lawsuits are settled or dismissed on motions for summary judgment. Many cases
that are settled before trial are settled during the mediation process. Many states court rules
provide that statements made in mediation are not admissible in litigation. Accordingly,
defendants and their attorneys may feel safer making an apology in the course of mediation.
Mediation often provides a place where the parties can participate in the settlement discussions
and negotiations while being assisted by the mediator and with the advice of their attorney. A
skilled mediator may be able to create an opportunity for a discussion that might include an
apology.
Often, we believe litigation is only about the money, but a significant issue in litigation is the
anger, non-economic issues and other emotional issues. Mediation can be successful when
parties can have a discussion in a setting outside the normal litigation routine. Often this can be a
discussion that does not regularly occur in litigation. Mediation provides a relatively safe
environment to offer an apology although the mediation itself may be a relatively long time after
the incident giving rise to the apology.
An apology (or expression of empathy) can be useful in mediation. For a defendant to say that
they are sorry this happened may help with the non-economic needs of the plaintiff. Mediation
can provide a relatively safe avenue for a defendant to express an apology or expression of
empathy (and for the other party to forgive).
E.

Why not apologize?

Making an apology entails some risk. Some may believe that when errors or mistakes are made
that disclosing the truth encourages litigation. Commentators have written much about the
transformational power of apologies. Perhaps one of the greatest reasons that people do not
apologize is the fear of how the person receiving the apology will react. The stakes become even
greater in an incident involving potential litigation and so it should come as no surprise that
many attorneys and insurance adjustors advise against the giving of an apology.
Our adversarial system has long discouraged the offer of an apology. Some attorneys believe,
and perhaps rightly so, that an apology may constitute adverse evidence or infer that you are at
fault. Some attorneys and laypeople believe that an apology is a sign of weakness or that an
apology may undermine the universitys defense or the merits of its position. Defendants and
defense counsel routinely worry that apologizing may only make things worse for the defendant.
They may view an apology as an admission that leads to almost certain liability. Accordingly,
many defendants avoid making an apology either on their own or on the counsel of their
attorneys or insurer.
Concern regarding the effect of an apology arises out of the use of the apology as an admission
of responsibility. An apology by a party may be admissible under the exceptions to the hearsay
rule allowing the admission of a partys own statements. Statements made in settlement
discussions or in the course of mediation may be protected by other rules of evidence or by the
local rules concerning mediation. Apologies made outside these arenas may be admissible.

The National Association of College and University Attorneys

Perhaps the safest case in which to make an apology is one in which it is clear that a mistake has
been made or a wrong committed.
At least one study suggests that plaintiffs lawyers view apologies differently than their clients
and that a full and complete apology raises the plaintiffs attorneys expectations concerning
settlement. Plaintiffs lawyers may set their aspirations higher and expect a larger settlement
following an apology.
Conversely another study indicates that an apology may lower jury verdicts. Researchers at
George Mason University and Oklahoma State University found that apologizing resulted in
lower frequencies of negligence verdicts. 5 Another study conducted by a University of Illinois
professor of law and of psychology resulted in similar findings:
Conventional wisdom has been to avoid apologies because they amount to an
admission of guilt that can be damaging to defendants in court, she said. But the
studies suggest apologies can actually play a positive role in settling legal cases.
Robbennolt surveyed more than 550 people, gauging their reaction to apologies offered
during settlement negotiations in a hypothetical injury case. She says apologies
generally reduced financial demands, increasing prospects for an agreement.
But the nature of the apology matters, according to a summary of her findings that will
appear in Court Review, a publication of the American Judges Association. Apologies
that accept fault have more impact than apologies that merely express sympathy, but
take no responsibility [sic]
Robbennolt says apologies that accept blame can be powerful psychologically, giving
plaintiffs a sense of closure and accountability that makes them less angry and more
willing to forgive.
The apology fulfills some of the goals that triggered the suit, such as a need for
respect, to assign responsibility and to get a sense that what happened wont happen
again, she said. So receiving an apology can reduce financial aspirations and make it
possible for parties to enter into discussions about settlement.
For defendants, apologies can reduce legal costs as well as damages because cases may
settle more quickly, said Robbennolt, who has studied the legal implications of
apologies for a decade.

The study involved mock trials involving a lawsuit against an auditor whose actions led to a negative outcome. The
researchers examined the outcome where the defendant offered an apology or justification (or both) as compared to
situations where the defendant remained silent. Steven Mehta, Apology Influences Jury Verdicts, New Study Finds,
MEDIATION MATTERS, October 7, 2009, (http://stevemehta.wordpress.com/2009/10/07/apology-infuences-juryverdicts-new-study-finds/). See also ScienceDaily.com, Apologies May Fuel Settlement of Legal Disputes, Study
Says, June 3, 2010, http://www.sciencedaily.com/releases/2010/06/100602121158.htm.
The National Association of College and University Attorneys

While plaintiffs respond favorably to apologies, another study by Robbennolt shows

that lawyers react more in line with traditional thinking that apologies are an
admission of guilt that can be used to leverage bigger settlements 6 .

VI. CLOSING THOUGHTS.

Universities and colleges are complex entities. Mistakes and incidents are going to occur on
every campus. University leaders should consider carefully whether an apology is warranted
following a mistake or incident on campus. Increasingly, universities exist in an
environment of increasing transparency and accountability. A university need not adopt a
system of apologizing to more carefully consider whether to offer one following an
incident or mistake. Often, people are resistant to making an apology since it means
admitting one has made a mistake. Ultimately, the maker of the apology has no control over
how the apology will be received.
Commentators write about the transformational qualities of an effective apology. A contrite
apology may reduce conflict and aid resolution while providing an opportunity for
forgiveness. An apology may also help preserve relationships, credibility and integrity.
There may be less damage to the universitys reputation where there is acceptance of
responsibility and apology. Some health care providers have experienced a decline in
lawsuits and reduced the time and attendant costs of litigation through a system of analyzing
or investigating incidents involving potential negligence and apologizing and resolving
those where they have concluded that a mistake was made. This approach is not inconsistent
with an assertive defense philosophy where these same providers vigorously contest
litigation where they believe there was no negligence.
Some may be reluctant to apologize because they do not want to appear fallible or because
they fear the potential response or reaction. Every institution, including universities and
colleges, is fallible. We can all look to recent history for instances in which public figures
and corporations may have been worse off because they apologized late or did not apologize
at all.
University counsel are in a unique position to guide the university in determining whether
an apology may be an important part of conflict or dispute resolution. An apology may be
an effective tool in addressing serious issues, incidents or problems on campus. It may not
always be the right tool in very situation but university officials should consider this option
when the university is involved in an incident or mistake where an apology may be
appropriate.

ScienceDaily.com, Apologies May Fuel Settlement of Legal Disputes, Study Says, June 3, 2010,
http://www.sciencedaily.com/releases/2010/06/100602121158.htm.
The National Association of College and University Attorneys

RESOURCES
Books:
Kandor, J. (2009). Effective apology: mending fences, building bridges, and restoring trust. San
Francisco, CA: Berrett-Koehler Publishers.
Lazare, A. (2005). On apology. New York, NY: Oxford University Press, USA.
Wojcieszak, Doug, Saxton, James, & Finklestein, Maggie. (2007). Sorry works!. Bloomington,
IN: AuthorHouse.
Smith, N. (2008). I was wrong. New York, NY: Cambridge Univ Pr.

Websites:
Kador, J. (n.d.). Effective apology. Retrieved from http://www.effectiveapology.com/
Kador, J. (n.d.). Effective apology blog. Retrieved from http://blog.effectiveapology.com/

Articles:
Goodman, D. (2009, July 20). Saying `sorry' pays off for U. of Michigan doctors. Associated
Press. Retrieved from http://abcnews.go.com/US/wireStory?id=8128259
Lazare , A. (2009). Go ahead, say youre sorry. Psychology Today, 40-43, 76-78.
Levi, D. (1997). The Role of apology in mediation. New York University Law Review, 72, 11651210.
Mehta, S. (2009, October 7). Apology influences jury verdicts, new study finds. Retrieved from
http://stevemehta.wordpress.com/2009/10/07/apology-infuences-jury-verdicts-new-study-finds/
Wojcieszak, D., Banja, J., & Houk, C. (2006). The Sorry works! coalition: making the case for
full disclosure. Journal on Quality and Patient Safety, 32(6). Retrieved from
http://www.jointcommission.org/NR/rdonlyres/5E597FEF-6F86-480D-A1E2CDD6CB491D3E/0/Sorry_Works.pdf

The National Association of College and University Attorneys

Hypothetical 1
Your university is served with a number of investigative subpoenas by the RIAA. Your IT
department identifies the students from the IP addresses and other information contained in the
subpoena. Several of the students settle with the RIAA, but one student refuses to do so. This
student repeatedly and adamantly asserts that they did not download any music. Some time
after the subpoena is served, the RIAA calls to confirm that you have identified the correct
student. The student is sued in federal court and shortly before trial, RIAAs national counsel
asks you to reconfirm that you have identified the correct student. You dutifully contact your IT
department again and ask them to do so. Your IT department calls you a little later and informs
you they have made a mistake and identified the wrong student. The misidentified student is
one of your honor students and has incurred approximately $15,000 in legal fees defending the
litigation initiated by the RIAA.
Hypothetical 2
Your Vice President for Human Resources calls and relates that for a significant portion of your
workforce (over 400 employees) you have over withheld federal income taxes for the current
and two previous years. The mistake is the result of an error in the formula for computing
payroll taxes. You learn that the over withheld taxes could amount to as much as $300 to $500
per employee and that the employees would need to file amended returns for the two prior
years to obtain the refunds.
Hypothetical 3
At one of your universitys hockey games, a fan seated behind your teams goal is struck in the
face by a puck deflected above the glass from a slapshot from one of your teams players. The
area where the fan was seated is behind the goal but above the glass behind the goal. The
area is protected by a net that extends from the goal to the ceiling of your arena. The puck
passes through the net hitting the fan. The fan suffers five broken teeth which are replaced with
caps and suffers some mild but permanent scarring above the lip.
Hypothetical 4
While at an internship site, one of your universitys nursing students makes an error in
administering too high a dose of a drug, leading to serious injuries to a patient. The student
confuses two bottles of the same drug with similar labeling, but different strengths.
Hypothetical 5
An employee of your university is forced to find another job after she turns down the sexual
advances of a coworker. The employee is terminated for performance issues, but complains
following the termination that she was sexually harassed and fired for reporting the harassment.
After the incident is investigated, you learn that the employee complained to her manager about
the sexual harassment. It appears that the harassment complaint was overlooked or ignored
and the employee suffered retaliation as a result of the complaints to her manager.
Hypothetical 6
During a campus renovation project, your university constructs a pedestrian bridge over a deep
ravine on campus. Not anticipating that students will leap off the bridge, it is constructed with
relatively low sidewalls. Over time, several students leap off the bridge suffering serious
injuries, and in one case death. It appears that some of the incidents are related to horseplay
fueled by alcohol, and others may have been suicide attempts.