Evaluating non-disclosure of errors and healthcare organization: a case of bioethics consultation.
Sometimes medical errors should not be disclosed. We report a case of semen samples exchange, during a homologous artificial insemination procedure, where a bioethics consultation was required. The bioethics consultation addressed ethical and legal elements in play, supporting non-disclosure to some of the subjects involved. Through a proper methodology, gathering factual and juridical elements, a consultant can show when a moral dilemma between values and rights-privacy versus fatherhood, in our case-is unsubstantial, in a given context, because of the groundlessness of the value or the right itself. However, being the error elicited by organizational factors, a broader ethical pronouncement was needed. Under such circumstances, ethical evaluation should engage in a sort of 'ethical-based root-cause analysis', linking ethical principles to quality aims and showing the opportunity to integrate ethical methodology in healthcare management. From this perspective, errors may become an incentive to promote high-quality organizations, attending to the central value of person even through the organizational process.
Fondazione Lanza, via Dante 55, 35139, Padua, Italy. massimiliano.colucci@fondazionelanza.net.
Massimiliano
M
Colucci
Department of Molecular Medicine - Legal Medicine, University of Padua, Padua, Italy.
Anna
A
Aprile
Fondazione Lanza, via Dante 55, 35139, Padua, Italy.|Bioethics Service, Hospital of Padua, Padua, Italy.
Renzo
R
Pegoraro
D003695:Delivery of Health Care / Q000941:ethics* / Q000458:organization & administration*; D030881:Disclosure; D026822:Ethicists / Q000592:standards*; D004991:Ethics, Institutional; D004992:Ethics, Medical; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007317:Insemination, Artificial, Homologous / Q000379:methods; D019300:Medical Errors; D028681:Moral Obligations; D012017:Referral and Consultation
Bioethics consultation; Error disclosure; Insemination artificial homologous; Medical error; Organizational ethics; Quality of healthcare