Disclosure of medical error to parents and paediatric patients: assessment of parents' attitudes and influencing factors.
OBJECTIVE
To assess parental preferences for medical error disclosure and evaluate associated factors.


METHODS
Prospective survey.


METHODS
Hospital for Sick Children, Toronto, Canada.


METHODS
Parents of inpatients and outpatients.


METHODS
Anonymous questionnaire administered on May to August 2006, surveying demographic characteristics and identifying parents' thresholds for disclosure using a vignette with six levels of harm.


METHODS
Preferred thresholds for parent and patient disclosure and associated factors.


RESULTS
99% of 431 parents (181 inpatients, 250 outpatients) wanted disclosure if there was potential or actual harm versus 77% if there was none (p<0.0001). Most parents (71% vs 41%) wanted their child similarly informed (p<0.0001). Parental age, education, experience with error and child's age did not affect preferences for disclosure. Parents of inpatients (p=0.03, OR 1.65, 95% CI 1.04 to 2.62) and those born in Asia (vs North America) had a lower disclosure threshold (p=0.014, OR 2.4, 95% CI 1.2 to 4.9), and administering the survey with increasing harm had a higher disclosure threshold (p<0.0001, OR 2.46; 95% CI 1.58 to 3.83). EXPERIENCE WITH ERROR: (p=0.05, OR 1.5, 95% CI 1 to 2.2) and child age (eg, <or=6 years vs >or= 11 years (p<0.0001, OR 2.74, 95% CI 1.73 to 4.33)) directly affected preferences for informing the child. Asian parents had a lower threshold for informing the child than North American parents.


CONCLUSIONS
Most parents want disclosure and want their child informed of errors with harm. While parental birth country, experience with error and patient age influenced parents' desire for disclosure to their child, the details of disclosure warrant study.
Matlow
A G
AG
Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada. anne.matlow@sickkids.ca
Moody
L
L
Laxer
R
R
Stevens
P
P
Goia
C
C
Friedman
J N
JN
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000941:ethics / Q000523:psychology*; D008875:Middle Aged; D009864:Ontario; D010290:Parents / Q000523:psychology*; D028701:Patient Rights / Q000941:ethics; D010372:Pediatrics / Q000941:ethics*; D011446:Prospective Studies; D012720:Severity of Illness Index; D014342:Truth Disclosure / Q000941:ethics*; D055815:Young Adult