Medical errors occur and are sometimes unavoidable. Physicians generally, but not always, have ethical and moral obligations to disclose their errors to the patient. Because common medical errors can be expected, physicians are obligated to work within health systems toward reducing systems flaws that promote errors. However, the obligations of physicians to disclose errors made by others are less clear. This article discusses the professional ethics involved in disclosing and preventing medical errors.
Two unrelated patients with Friedreich ataxia were deficient in the activity of the enzyme lipoamide dehydrogenase (LAD). The enzymes from the patients' platelets differed significantly from controls in activity, in KM for lipoamide, and in KM for NADH. The data are consistent with a structural mutation of the gene coding for LAD.
Good care for dying patients has always been an obligation in medicine. To fulfill this obligation, physicians must embrace the integralness of dying in life, must recognize when to submit to death and dying with equanimity, and must develop attentive and individualized plans of care for each patient. Approaches to care should have, at their core, a reinvigorated commitment to communication between health professionals and patients and their intimates.
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