Kathleen Clark, Ph.D., J.D., who provided this entry, has practiced law and mediation in the San Francisco Bay Area for twenty years. She is the founder/CEO of Servant Lawyership. She practices law, convenes symposiums, and writes and speaks on collaborative practices in health care.

Michael Woods died of a heart attack on a gurney in the emergency room of Kent Hospital in Warwick, Rhode Island. A heart monitor was ordered but the order was never carried out.

Michael’s older brother, actor James Woods, sought compensation for his brother’s son, Peyton, but more than that, he wanted acknowledgement of responsibility, accountability, and an apology. Although Woods knew that litigation would only provide his family money, nothing more, he saw litigation as the only option he had.

The case proceeded to trial with Sandy Coletta, the new CEO of Kent Hospital, playing an active role. During the third week of trial, Coletta told her attorneys that she “absolutely” needed to talk with Woods, personally. At first, Woods resisted.

Decof told me that in his experience, he’d never seen or heard of a situation in which a public apology and acknowledgment, had occurred in the middle of a medical malpractice trial, especially when a settlement was involved. Decof asked Woods to meet with Coletta, knowing that a meeting was the only avenue to acknowledgment of responsibility and an apology. He suggested that “Woods might be able to look at the hospital differently through Coletta”.

That’s exactly what happened.

Coletta told Woods, “I don’t know if anyone from Kent has ever said this to you, but I am so sorry about what happened to your brother.” She acknowledged that “Mistakes were made” and “the hospital did not follow through on the order.” According to Decof, the apology shifted Woods’ frame of mind from “search and destroy to a conciliatory”. Woods said he transitioned from hurt and anger to hope.

Although the advent of this new practice, collaborative law in health care, has been daunting, my spirit, determination, and dedication to collaborative practices after adverse medical events was reinvigorated by this 2009 medical malpractice/wrongful death case of Michael Woods. The case was filed in July, 2006, had all the traditional elements of medical malpractice litigation. James Woods was angry, bitter, and alienated, feeling disrespected and unrecognized. Although James’ mother was not a party, she was an integral part of the litigation process.

By the end, the case had many elements of reconciliation: apology, acknowledgment, forgiveness, and collaboration, particularly transformative because the case was considered unsettlable. For me, this case was and continues to be about our shared humanity, understanding, and caring about each other.

Were you aware that President Obama signed a bill in December that included a resolution offering “an apology to all Native Peoples on behalf of the United States”? I wasn’t.

When I surfaced from reading an article on apologies the other day, I noticed a tweet from Simon Cohen, aka globaltolerance: “Imp news: Obama apologises to Native Americans http://bit.ly/5qOGEG.” I jumped to the link and read Sean McCollum’s Teaching Tolerance article on the passage and signing of the 2010 Defense Appropriations Act last month which included an apology “to all Native Peoples for the many instances of violence, maltreatment, and neglect inflicted on Native Peoples by citizens of the United States.”

Where was this news? I searched the Web for a news story. Surely there had been coverage of this. Nothing substantial surfaced. As the Teaching Tolerance post points out, news attention was elsewhere–namely, McCollum states, on Tiger Woods and health reform.

An apology for institutionalized, horrific, and sustained transgressions against Native Americans in this country was buried in a defense bill and eclipsed in the news.

While an apology doesn’t erase transgressions–especially of this magnitude–it is important. And giving voice to the apology, to me, would make it more real. Perhaps this is a good time to revisit the power of apology and why it’s needed, and in the process build discussion–and visibility–around this apology.

According to On Apology author, Aaron Lazare, in an article in The Compassionate Instinct, “there are four parts to the structure of an effective apology…acknowledgment of the offense; explanation; expressions of remorse, shame, and humility; and reparations.” An effective, heartfelt apology can lead to forgiveness, even reconciliation, according to Lazare. To do this, he writes, it must satisfy one or more of seven psychological needs of those offended: the restoration of dignity, validation that the victim was not responsible, agreeing that the harm committed was wrong, assuring that the offended party is safe from a repeat offense, reparative justice, reparations, and dialogue between the offender and offended

While the resolution clearly makes no reparations, perhaps we can see it in the light of a work in progress and learn from it. According to Sean McCollum, “it finally owns up to this country’s record of ill-conceived, bigoted, and often sadistic treatment of Native Americans. And perhaps, like any honorable apology should, it sets the stage for making amends.”

Now if it would only get some coverage… Pass it on.

This reflection is from Thom Andrews, director of Kalamazoo’s Season of Forgiveness.

During this past weekend we again marked the life and legacy of Dr. Martin Luther King, Jr. The question it brought to mind for me this year was this: can forgiveness make its way into mainstream civic discourse?

One of the many unsettling dynamics in our political arena is how thin-skinned our politicians make themselves out to be (though they probably aren’t so). Individuals are quick to take great personal offense at the mere implication of a slight, and these individuals are quick to go to the media and speak of their rage. The strategy becomes not so much to rise above the fray as to become the fray that pushes down the other person.

Exceptions to this political game seem few and far between. I wonder, however, if they aren’t so few but simply less reported. One recent exception I discovered is in Malaysia where, in the wake of multiple attacks on churches, Christians and Muslims and “even politicians across the political divide” condemned the attacks. They made statements and took actions so that “an air of repentance and forgiveness prevailed.” The writer called the acts “unprecedented.”

Wisdom and maturity can prevail over shallow political maneuvering. Let’s help make this our future.

Quote for reflection throughout the week
We must develop and maintain the capacity to forgive. He who is devoid of the power to forgive is devoid of the power to love. There is some good in the worst of us and some evil in the best of us. –Martin Luther King, Jr.

From the web
Here is the article describing the situation in Malaysia that I mention above.

This article echoes Dr. King’s call to disarm our enemies with love.

Last summer, while walking to one of my favorite places, the Ballard Locks, I noticed a lovely water feature in the garden that I’d not “seen” before. I’d walked by it numerous times, but missed it, totally. Even though I use these walks as a time to slow down and take in my surroundings, I’d completely missed this gem.

I’ve noticed other places around town that I’ve completely missed, too. And conversations–well, there are times that it’s not just a flagging memory that is at work. I allow myself to be distracted. Then I strain to catch the thread of the conversation.

There are so many things I’ve missed in life. I continually struggle to hold my attention in the present moment, sometimes with greater success than others. But the moments I’ve missed could–if translated to money–probably make a dent in the national debt.

It’s one of those things that’s simple to say, challenging to do. Noticing, listening, being present to each moment is like holding on to a fist full of sand–the tighter I squeeze, the more sand escapes.

In these tough times, the one thing we all have to give is our presence, our attention. Events like the earthquake in Haiti easily remind us how fleeting life is and how all we really have is the moment and our connections to others, to animals, and to nature. Right now, I renew my promise to witness the unfolding of each moment with a steady presence and when I stray, to start over again.

I watched the first program in the three-part PBS series, This Emotional Life last night. It was fascinating to see how “families, friends, and lovers” navigated the terrain of human connection–especially when it was terribly challenging. This kind of information should be taught in school–after all we spend our lives in relationship to others, yet often learn relational skills on the fly.

The series “explores improving our social relationships, learning to cope with depression and anxiety, and becoming more positive, resilient individuals. Each episode weaves together the compelling personal stories of ordinary people and the latest scientific research.” If you missed the first program, I encourage you to catch the next two, which are airing on many public television stations tonight and tomorrow at 9 p.m. (check local listings).

In an article about the series on the Huffington Post, Xavier Amador, a consultant for the series and a clinical psychologist pointed out the importance of emotions that are painful in helping us connect with one another. “When we are sad, people reach out to us and we feel the desire to be held, cared for, loved. Anxiety often has the same effect. And when we come together we can then pursue common causes such as the search for food, creating shelter, defense against predators–our genes survive and are passed on to the next generation.”

We all suffer. We all are imperfect. How best do we relate and support each other knowing this? So far, I’m finding that This Emotional Life is providing some good insights.

Here’s some food for thought for the holidays from Thom Andrews, director of Kalamazoo’s Season of Forgiveness. Thank you, Thom.

It’s the holidays. It’s the end of a year and the end of a decade.

As we gather with family and look back at our lives and the times in which we live, what posture will we assume? That is, what perspective will we take?

I suggest gratitude. Gratitude recognizes the fragility and randomness in life and takes nothing for granted. In practicing gratitude, we are mindful of each moment and grateful for what we have and what we receive. Gratitude acknowledges and expresses our humility, recognizing that there are no entitlements and we are not in control of what life dishes out. Gratitude is one of the fundamentals of forgiveness (along with kindness and generosity).

In this season, be grateful. You’ll be happier and healthier if you do.

Quote for reflection throughout the week
Forgiveness is the giving, and so the receiving, of life. –George MacDonald

From the web
Recent scientific studies showing that gratitude leads to a healthier, happier life.

Keeping with the theme of emotional mine fields.. Being a teen and parenting a teen create some of the most challenging and emotionally volatile times in one’s life. In a Psychology Today blog article by Carl Pickhardt, Ph.D., he provides some food for thought for parents and teens this holiday season.

In it, he states “that the final act of letting go of adolescence for both parents and teenagers needs to be forgiveness. Each party must be able to look back at the struggle between them and let go any resentment by saying to the other: ‘It is over now. And I want you to know that I believe you tried your best even when you were doing your worst. And that your worst was not all that you did. You also gave me much that was good, much that I value and for which I shall always be grateful.’”

“I would like to make a proposal for all of us for this holiday season,” writes Michelle Chadwick in a Dallasnews.com op ed piece. “Think of one person in your life whom you believe has wronged you. It can be a family member, a neighbor, a former friend, or a coworker. You know, the one whose very presence makes you want to dig up something from the past and rehash it again. And then make a conscious decision to forgive them and then, let it go (whatever “it” is).”

If the holidays are a mixed bag of emotions and interpersonal challenges for you, it’s worth reading this short article.

When I returned home from a trip on Monday, I was confronted by the front page headline in the Sunday Seattle Times “A path to murder,” about the life of Maurice Clemmons who murdered four police officers in Parkland, Washington. In the same issue was the Parade Magazine headline, “The Power of Forgiveness,” describing Nelson Mandela’s call for reconciliation as portrayed in the movie Invictus (opening December 11th) which chronicles his support of South Africa’s rugby team in an effort to bring South Africans together “through the universal language of sport.”

Offering forgiveness may seem outrageous to some when confronted with an overwhelming transgression like murder.  But reading the story about Invictus that held up the actions of Nelson Mandela in the face of tremendous, systemic injustice, was a reminder that it can and has been done. But how is forgiveness of such magnitude possible?

Everett Worthington, PhD, a leader in the field of forgiveness, experienced such a transgression in his own life which tested his resolve to practice what he preached. He used a process called “emotional replacement,” which he developed and studies, to forgive the man who murdered his mother.

In his book, Five Steps to Forgiveness, he explains that “trauma seems to cause the emotional centers of the brain to become extremely active, and it changes emotional experience strongly. Imagining a traumatic scene and pairing it with the emotion of compassion most likely reprogrammed my emotions of rage and fear.”

Worthington found humanity in the young man who murdered his mother. “People who hurt or offend us often do so because they’re conditioned by their past,” he writes. He was able to use that perspective to find compassion for and forgive his mother’s murderer without jettisoning a search for justice.

For most of us, forgiveness requires constant practice, building mental and emotional muscle that can hold the tension of the pain of transgressions alongside a broader understanding and compassion for the person or people who harm us or our loved ones. It’s not easy, but we can look to the example of Nelson Mandela, Everett Worthington, or others closer to us for inspiration.

For more on forgiveness from Everett Worthington and Fred Luskin, PhD, another leader in the field, listen to our podcasts.

In a recent Case Western Reserve release, the university announced that researchers from the Frances Payne Bolton School of Nursing and the College of Arts and Sciences at Case Western will begin groundbreaking studies to understand what drives the dying to live long enough to personal and interpersonal issues.

With the research data, they will design interventions to help patients in hospice care and families before and after the person passes.

Before now, end of life research primarily focused on making the patient comfortable by easing suffering or discomfort from the illness.

But, the approach of Barbara Daly and Mary Jo Prince-Paul from the School of Nursing and Julie Exline from Arts and Sciences is to relieve psychological distress by marshaling the patient’s inner strengths and social connections.

These qualities include the resilient feelings of hope, optimism and connectedness that they mustered to make it through difficult and even life-threatening situations before their terminal illnesses. Marshaling these inner resources has been shown to improve the psychological outlook of healthy people, and the researchers want to find out the benefits for those severely ill.

Forgiveness will also be a focus of the study, which is partially funded by the Fetzer Institute. Exline, who has studied forgiving oneself, others and God over the past decade, will survey family members before and after the death of the loved one to see how hospice workers can help them as they undergo the emotional stress of caring for this seriously ill family member and then the challenges of bereavement.