Ethical Standards for Disclosing a Medical Error

There is an apparent need for enhanced formal control over providers responses to medical errors, and particularly over their performance regarding error disclosure. Such efforts need to strive for clear ethical and legal vision in both disclosure intent and content. Providers should enforce the maintenance of personal and professional integrity by encouraging ethical conduct that is in the best interests of the patient, and at the same time adhere to the law despite its current ethical constraints. This review discusses the necessary disclosure components that would meet such an encompassing vision, and suggests a set of ethical standards that are specific to the context of error disclosure.

Ethical Standards for Disclosing a Medical Error

There is an apparent need for enhanced formal control over providers responses to medical errors, and particularly over their performance regarding error disclosure. Such efforts need to strive for clear ethical and legal vision in both disclosure intent and content. Providers should enforce the maintenance of personal and professional integrity by encouraging ethical conduct that is in the best interests of the patient, and at the same time adhere to the law despite its current ethical constraints. This review discusses the necessary disclosure components that would meet such an encompassing vision, and suggests a set of ethical standards that are specific to the context of error disclosure.

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  • DeVille K, Elliott C. To err is human: American culture, history, and medical error. In: Rubin SB, Zoloth L, editors. Margin of Error: The Ethics of Mistakes in the Practice of Medicine. Hagerstown, MD: University Publishing Group; 2000.
  • Kohn LT, Corrigan JM, Donaldson MS. To Err is Human: Building a Safer Health Care System. Washington, DC: National Academy Press; 2000.
  • Joint Commission on Accreditation of Healthcare Organizations. Revisions to Joint Commission Standards in Support of Patient Safety and Medical Health Care Error Reduction. Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations; 2001.
  • National Quality Forum. Safe Practices for Better Healthcare. Washington, DC: National Quality Forum; 2006.
  • Gallagher TH, Studdert LL, Levinson W. Disclosing harmful medical errors to patients. N Engl J Med. 2007;356:2713–9.
  • Raper SE. No role for apology: remedial work and the problem of medical injury. Yale J Health Policy Law Ethics. 2011;11:267–330.
  • American Medical Association Code of Ethics. Opinion 1.02 the relation of law and ethics. Available at: http://www.ama-assn.org/ama/pub/physician-resources/medicalethics/code-medical-ethics/opinion102.page Accessed September 20, 2012.
  • Hamm G, Kraman SS. New standards, new dilemmas: reflections on managing medical mistakes. Bioethics Forum. 2001;17:19–25.
  • Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, Hebert L, Newhouse JP, Weiler PC, Hiatt H. The nature of adverse events in hospitalized patients: results of the Harvard Medical Practice Study II. N Engl J Med. 1991;324:377–84.
  • Spitzberg BH, Cupach WR. Interpersonal Communication Competence. Beverly Hills, CA: Sage; 1984.
  • Gallagher TH, Waterman AD, Ebers AG, Berwick DM, Brennan TA. Patients’ and physicians’ attitudes regarding the disclosure of medical errors. JAMA. 2003;289:1001–7.
  • Lamb RM, Studdert DM, Bohmer RMJ, et al. Hospitals’ error disclosure practices: results of a national survey. Health Aff (Millwood). 2003;22:73–83.
  • Crigger NJ, Meek VK. Toward a theory of self-reconciliation following mistakes in nursing practice. J Nurs Scholarsh. 2007;39:177–83.
  • Waring JJ. Beyond blame: cultural barriers to medical incident reporting. Soc Sci Med. 2005;60:1927–35.
  • Kaldjian LC, Jones EW, Rosenthal GE, Tripp-Reimer T, Hillis SL. An empirically derived taxonomy of factors affecting physicians’ willingness to disclose medical errors. J Gen Intern Med. 2006;21:942–8.
  • Barach P, Small SD. Reporting and preventing medical mishaps: lessons from nonmedical near miss reporting systems. Br Med J. 2000;320: 759–3.
  • Berlinger N. Avoiding cheap grace medical harm, patient safety, and the culture(s) of forgiveness. Hastings Cent Rep. 2003;33:28–36.
  • Kraman SS, Hamm G. Risk management: extreme honesty may be the best policy. Ann Intern Med. 1999;131:963–7.
  • COPIC. COPIC’s 3Rs program, 2003. Available at: http://www.callcopic.com./copicservices/safety-and-risk/pages/3rs.asp; accessed September 20,2012
  • Hannawa AF. “Explicitly implicit”: examining the importance of physician nonverbal involvement during error disclosures. Swiss Med Wkly. 2012;142:W13576.
  • Levinson W. Disclosing medical errors to patients: a challenge for health care professionals and institutions. Patient Educ Couns. 2009;76:296–9.
  • Chan DK, Gallagher TH, Reznick R, Levinson W. How surgeons disclose medical errors to patients: a study using standardized patients. Surgery. 2005;138:851–8.
  • Evans SM, Berry JG, Smith BJ, Esterman AJ. Anonymity or transparency in reporting of medical error: a community-based survey in South Australia. Med J Aust. 2004;180:577–80.
  • Schwappach DLB, Koeck CM. What makes an error unacceptable? A factorial survey on the disclosure of medical errors. Int J Qual Health Care. 2004;16:317–26.
  • Mazor KM, Reed GW, Yood RA, Fischer MA, Baril J, Gurwitz JH. Disclosure of medical errors: what factors will influence how patients will respond? J Gen Intern Med. 2006;21:704–10.
  • Leape L, editor. When Things Go Wrong: Responding to Adverse Events. Burlington, MA: Massachusetts Coalition for the Prevention of Medical Errors; 2006.
  • Hoy EW. Disclosing medical errors to patients. Ear Nose Throat J. 2006;85:410, 413. Kachalia A, Shojania KG, Hofer TP, et al. Does full disclosure of medical errors affect malpractice liability? The jury is still out. Jt Comm J Qual Saf. 2003;29:503–11.
  • Lazare A. Apology in medical practice: an emerging clinical skill. JAMA. 2006;296:1401–4.
  • Berlinger N, Wu AW. Subtracting insult from injury: addressing cultural expectations in the disclosure of medical error. J Med Ethics. 2005;31:106–8.
  • Cohen R. Assessing professional behaviour and medical error. Med Teach. 2001;23:145–51.
  • Vincent C, Young M. Why do people sue doctors? A study of patients and relatives taking legal actions. Lancet. 1994;343:1609–13.
  • Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 5th ed. New York, NY: Oxford University Press; 2001.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
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