Disclosure of adverse events and errors in healthcare: an ethical perspective.
Adverse events and medical errors affecting patient care are recognised internationally as major problems in medicine. The failure of health care professionals and health institutes to address this problem has threatened to undermine public confidence in the health care system as a whole. Less focus has been directed at the ethical issues raised by negative outcomes of care, specifically the issue of disclosure. Efforts to prevent negative outcomes of care must be supplemented by policies of increased honesty and openness with patients and their families about adverse incidents. Disclosure should be made easier, not riskier, for healthcare practitioners so clinicians can learn from mistakes and improve patient care. Ethical guidelines for error disclosure must distinguish between disciplinary action and reporting of adverse incidents. Disclosure of negative outcomes requires tact and good communication skills. Healthcare institutions should provide training for the clinicians in this area, if necessary. As a general rule, patients should be informed of unexpected adverse incidents as soon as possible. Medical staff should be rewarded for adverse event reporting and protected from institutional retaliation on account of errors made in health care.
Hébert
P C
PC
Clinical Ethics Centre, Sunnybrook and Women's College Health Science Centre, Joint Centre for Bioethics and Department of Family and Community Medicine, University of Toronto, Toronto, Canada. philip.hebert@swchsc.on.ca
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D064420:Drug-Related Side Effects and Adverse Reactions; D004991:Ethics, Institutional; D004995:Ethics, Professional; D006282:Health Personnel / Q000331:legislation & jurisprudence / Q000523:psychology / Q000592:standards; D006801:Humans; D016365:Liability, Legal; D019300:Medical Errors / Q000009:adverse effects* / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D011785:Quality Assurance, Health Care / Q000592:standards; D014342:Truth Disclosure