Disclosure and Prevention of Medical Errors

Abstract

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.

An empirically derived taxonomy of factors affecting physicians’ willingness to disclose medical errors

“…[1][2][3][4][5][6][7][8][9][10] Disclosure of medical error through direct communication with patients and their families is also an integral part of patient care, [11][12][13][14] and candor about errors between colleagues is essential to professional learning. [15][16][17][18] However, there are diverse and potent factors that impede a physician's willingness to disclose errors to institutions, patients, and colleagues.…”

“…[15][16][17][18] However, there are diverse and potent factors that impede a physician's willingness to disclose errors to institutions, patients, and colleagues. 5,6,12,16,[19][20][21][22][23][24][25] Recommendations to address these impediments by changing professional culture 7,8,[25][26][27][28][29] are accompanied by sobering descriptions of the tension between the transparency promoted by the patient safety movement and the silence induced by the malpractice system. 30,31 The number and variety of variables affecting a decision to disclose an error pose serious challenges for those trying to design systems and promote practices that increase disclosure.…”

Medical errors in hospitalized patients

“…Honestidade e desculpas são obrigatórios. Admitir os erros para os pacientes não deve ser somente uma questão ética, porém um pré-requisito prático para prevenções futuras de erros 25 .…”

Achieving closure through disclosure:

“…6,7,9 Disclosure is considered an ethical imperative born of the trusting relationship between patient and provider. 10,11 A systems approach to disclosure has been advocated to promote a team approach to patient safety. 12,13 The Hospital for Sick Children is a tertiary and quaternary care pediatric academic health sciences center.…”