title: Committee Opinion No. 681: Disclosure and Discussion of Adverse Events.
abstract: Adverse outcomes, preventable or otherwise, are a reality of medical care. Most importantly, adverse events affect patients, but they also affect health care practitioners. Disclosing information about adverse events has benefits for the patient and the physician and, ideally, strengthens the patient-physician relationship and promotes trust. Studies show that after an adverse outcome, patients expect and want timely and full disclosure of the event, an acknowledgment of responsibility, an understanding of what happened, expressions of sympathy, and a discussion of what is being done to prevent recurrence. Surveys have shown that patients are less likely to pursue litigation if they perceive that the event was honestly disclosed. Barriers to full disclosure are many and include fear of retribution for reporting an adverse event, lack of training, a culture of blame, and fear of lawsuits. To reduce these concerns, it is recommended that health care facilities establish a nonpunitive, blame-free culture that encourages staff to report adverse events and near misses (close calls) without fear of retaliation. Health care institutions should have written policies that address the management of adverse events. Having a responsive process to inform and aid the patient, loved ones, and practitioners is required. A commitment on the part of all health care practitioners and institutions to establish programs and develop the tools needed to help patients, families, health care practitioners, and staff members deal with adversity is essential.
mesh_terms: D005260:Female; D006176:Gynecology; D058016:Health Facility Administration; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D019300:Medical Errors / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D009774:Obstetrics; D016134:Organizational Policy; D010817:Physician-Patient Relations; D035502:Trust; D014342:Truth Disclosure / Q000941:ethics