We are all feeling many strong emotions in response to the recent death of George Floyd, the civil unrest, and the long-standing institutional racism and injustices in health, education, housing and wealth that are more exposed than ever. racism
As an expert in improving patient safety and health system performance, I believe the way we respond to harmful medical errors can offer insights into how we can make progress with racism. When clinicians harm a patient, the response can be shame, guilt or love. With shame, we feel, “I am a bad person.” Shame makes us small and stalls progress in preventing harm in the future. With guilt, we feel, “I did a bad thing.” Guilt turns us inward, narrowing the focus of potential solutions. Love allows the person to both be accountable and to work with others to reduce the risk that the event happens again.
A love response requires three things: An apology and acceptance of responsibility; a transparent disclosure of what happened; and a commitment to make amends and work with others to ensure the mistake does not happen again. Conversations about race might be more productive if approached the same three ways.
Furthermore, there are two types of apologies a clinician can make after harming a patient: an apology of acknowledgment and an apology of responsibility. An apology of acknowledgment states, “I am sorry you were harmed.” An apology of responsibility states, “I am sorry that I harmed you.”
Apologies of acknowledgment do little to heal or build trust. Apologies of responsibility are a potent pill that helps heal and builds trust.
Many are asking what will work in addressing institutional racism and systemic inequities in power, health, wealth and education. In my opinion, we need to build trust, which can start with whites publicly apologizing for their contributions to racism—whether intentional or not.
Most of the public discourse has been apologies of acknowledgment that infer, “I am sorry you suffer from racism.” Few individuals have made apologies of responsibility. As a white man of privilege, I would like to start the process by apologizing for contributing to racism and the inequities and injustices that result. As a society, we need to begin with an apology of responsibility followed by a transparent accounting of our history of racism and a commitment to work together for change.
I call these conversations of love, because love empowers apologies of responsibility. Love can provide empathy for all, recognizing that the vast majority of people are loving and all of us want to be loved. Love can house the strong feelings that will emerge, so we can really hear and seek to understand each other.
These conversations can take place in communities where we work, worship, live, learn, congregate and collaborate. They can be jointly hosted by persons of color and a white person. To work, they need to occur with the uplifting and connecting energy of love. While they are not easy conversations to have, they will begin the healing process and will continue to grow in number. Along the way, we learn what works to make things substantively better, and we do what works.
Change progresses at the speed of trust. Trust between communities of color and white people is terribly broken. But it can be mended. Our country and our communities are ready for change. An Aspen Ideas report on education reform concluded that “in any collective human endeavor there comes a moment; a moment when we know so much more about what to do; a moment when collective voices align around a common purpose; a moment when we can make the possible real.” For ending racism in America, that moment is now. Words are not enough; they do not substitute for action. We need action.
So let us start conversations of love. Let us create safe spaces for all and make an apology of responsibility. Let us acknowledge and mourn our history of racism, let us draw hope from the strengths in our communities, and walk together toward a better tomorrow.