Depression is fostered by the prolonged nature of the litigation, a sense of not being in control and the associated helplessness that both entail. Guilt may have the biggest impact on the physician's ability to tolerate the stress of litigation. In 1986, Charles stated that, while self-questioning is healthy and useful within the medical profession, it can be a weakness within the legal arena. Physicians take accusations of professional negligence very personally, as they may feel it reflects upon their judgment and abilities. Doctors may ruminate on what they might have done to prevent the loss.
Guilt can contribute to shame and a sense of isolation.
If staff or family do not know what is happening, they may withdraw, resulting in a perception of lack of support. Over half of the physicians who have gone through litigation felt their families suffered as well. Most spouses responded to the suit with a deep sense of loss, financial vulnerability and social awkwardness. It disturbs and frequently destroys couples' relationships, and provokes depression, anger, and anxiety in spouses and children as well as in the defendant physician. If these fears and worries are brought out into the light, they can usually be dispelled.