Why don't doctors accept their mistake when they have done, that too when it is their moral duty?

This is going to be a long answer.

There are a few terms that need clarification here

Mistake: an act or judgement that is misguided or wrong - mostly done unknowingly. The word ”judgement” is the key. I’ll explain later.

Medical Error: Usually an untoward event that happens inspite of taking necessary precautions to avoid it. There are meticulous systems in place to avoid errors. But, inspite of all the cross checks, errors do happen. But, most errors are detected and corrected and rarely life threatening.

Complication: Usually a negative event that happens after a particular activity (a surgical procedure or administration of a drug or an intervention) which is either a reaction of the body to the activity or a manifestation of the body to the modified anatomy). Most of the complications are known to the doctor before performing the activity. Usually the complication rates are quite low and the benefit outweighs the risk of complications.

Medical Negligence: Medical Negligence basically is the misconduct by a medical practitioner or doctor by not providing enough care resulting in breach of their duties and harming the patients. This is usually a lack of doing the basic treatment for the particular situation and neglecting their duty. The first 3 definitions don’t contribute to this.

Some Context before answering the question

The human body is an extremely complex thing. The way each organ works is very delicately balanced with the other organs. There are thousands of chemicals signalling every minute to maintain the body in a normal state.

Medical science has evolved over the last few centuries and astronomically over the last few decades. We understand the human anatomy, it’s functioning and it’s malfunctioning (diseases) to a significant extent. But there are still an unknown amount of things science has not figured out.

The normal human body and it’s functioning remains the same. Our understanding of it keeps improving. The diseases are different. Each person manifests differently for the same disease. One manifestation (symptom) can be the first sign of many different diseases. There are multiple treatments for one disease. Treating a disease needs a very complex decision making to make sure that it suits that particular patient and with the least amount of side effects.

Now, how does a doctor decide which treatment is best for that patient? There are multiple ways. There are textbooks, clinical trials, research papers and knowledge gained out of experience. Most of these treatments have evolved out of decades of treating patients with similar illnesses. The most important point is, no one can be absolutely sure about how any particular patient will respond to a particular treatment. The treatment may be a time tested one or a newer one that is less known (due to its recent availability) and still the response to the treatment of each patient is different and sometimes unpredictable.

Medicine is a science of probability. It is based on strong scientific evidence and knowledge. We know exactly how most things work in general. There is an element of probability because of the way each patient responds to the same treatment for the same disease. Now, here comes the judgement part. The doctor is forced to make a decision based on the probability of the treatment success. The judgement is based on the thousands of patients treated earlier by him and his colleagues. The judgement is based on the clinical presentation, the findings on examination and the investigations. Sometimes, a surgery is required just to make a diagnosis.

There are times when a diagnosis is extremely difficult or impossible to pin point. One disease can manifest like an other. This is when more judgement is required without adequate information to make the judgement. But, diseases don’t wait. A doctor cannot adjourn the case for a latter date to collect more evidence. A treatment has to be started ‘empirically’ to save the patient’s life. Here is where the probability and judgement play their roles. It takes decades of critical thinking and constant practice to be able to make the right judgemental call. It is every doctors prayer that his judgement is right for that patient. Unfortunately, sometimes, the human body tricks the doctor and the judgement goes wrong. Please note, this is not a mistake.

I don’t believe ANY doctor makes a mistake knowingly. Thinking that a doctor makes a mistake knowingly is like thinking that someone would purposely sabotage a space mission. I do agree that negligence can happen due to lack of infrastructure, lack of medical personnel, lack of adequate rest, lack of knowledge and rarely just lack of humane care for the patient.

Even after a perfectly performed surgery or intervention, patients can develop complications. These are known events that can happen to any procedure. Complications are NOT mistakes. They are known but unexpected events that happen, mostly due to the nature of the disease. Sometimes, it is impossible to do the surgery the way it was planned. This is again because, what you expect to find is not exactly what you find when you are halfway through surgery. Again you have to modify your decision based on what you find now. Every surgeon starts with the intention of doing the best for the patient. It is usually possible to do that. Sometimes, it’s not. Again, this is neither a mistake nor a lack of judgement. It is the variations in presentation of diseases.

Most patients somehow fail to recognise the fact that they have a disease. They somehow believe that everything is curable and life is eternal. They are surprised by their own diseases. People abuse their body for decades and are shocked by their consequences. This applies to the time when they present to the doctor for the first time.

Something very interesting happens once the doctor starts treating them, especially if it’s a surgical or interventional procedure. The patients who came with a chronicdisease, feel upset that the disease is still there and are surprised at the complications caused by the disease (eg. diabetes or cardiovascular disease). They expect to have a brand new body the moment treatment is started and tend to attribute all the symptoms that occur after the consultation to the treatment offered.

All medications have an effect and a side effect. Almost always, the effect is much more important that the side effect. There are also complications of a particular drug. For example, aspirin is an important drug in heart disease. But, it can cause gastric bleeding in some patients. It’s a probability and it is usually in favour of the effect and not the complication. That’s how most things work in medicine.

So, it is extremely unusual for mistakes, the way you think, to happen. If they do, it is extremely unusual for it to have been committed knowingly or negligently. Rare situations do happen which is trumpeted by the media for their own benefit. Bad elements exist everywhere and in every system. But I’m sure it is the least in medicine and it’s related fields.