title: When a physician harms a patient by a medical error: ethical, legal, and risk-management considerations.
abstract: Errors that harm patients are infrequently brought to the attention of these patients. The full disclosure of such medical errors is in the best interest of patients because it allows them to understand what has occurred, and to gain appropriate compensation for the harm that they have suffered. Physicians have been given little guidance regarding how to conduct a relationship with the patient after such an injury. We argue that the physician must continue to respect the patient, and communicate honestly with him or her throughout their relationship, even after the patient has been injured. It is painful to admit our errors, especially to those who have been harmed by them. Nevertheless, offering an apology for harming a patient should be considered to be one of the ethical responsibilities of the profession of medicine. Monetary compensation alone is not to be offered as a charitable gesture; rather, it should be accompanied by an apology to demonstrate the responsibility of the physician to the trusting patient. Full and honest disclosure of errors is most consistent with the mutual respect and trust patients expect from their physicians. Clearly, physicians' ethical responsibilities sometimes differ from their legal and risk-management responsibilities.
authors.affiliation: Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: D
authors.initials: D
authors.lastname: Finkelstein
authors.forename: A W
authors.initials: AW
authors.lastname: Wu
authors.forename: N A
authors.initials: NA
authors.lastname: Holtzman
authors.forename: M K
authors.initials: MK
authors.lastname: Smith
mesh_terms: D000328:Adult; D035881:Compensation and Redress; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000601:surgery*; D030881:Disclosure; D004992:Ethics, Medical; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008396:Maryland; D019300:Medical Errors / Q000009:adverse effects*; D028681:Moral Obligations; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D012308:Risk Management / Q000379:methods*; D012941:Social Responsibility; D035502:Trust; D014342:Truth Disclosure; D035642:Whistleblowing