Disclosure

Medical Mistakes and the Power of Disclosure

Patients and their families understand that mistakes happen. Patients are less likely to take legal action if their providers take care of them, treat them honestly and fairly, and make changes to ensure the error will never happen again.

To them, however, is a different matter.  It’s hard to admit to errors and harder still to apologize for them.  This is particularly true in the medical profession, where hospitals, under pressure, have historically discouraged doctors, nurses, and staff from talking about medical errors or taking actions to atone for them.

Fortunately, the medical profession’s attitude toward its own errors has radically changed in the past decade.  A culture of secrecy has given way to a culture of transparency, bringing profound benefits to providers and patients alike.

Of course, there are right ways and wrong ways to disclose, and knowing exactly how and when to do it can get complicated fast.  With a solid understanding of the issue, however, and with clear guidance from hospital administrators and policies, anyone can navigate the path from mistake to disclosure – and be empowered and healed in the process.

The Myths and Costs of Secrecy

For many years, the fear of litigation and a desire to preserve professional standing drove medical mistakes underground.  Providers, believing that admitting errors would damage their reputations and lead to lawsuits, hid their mistakes when they could and stonewalled about them when they couldn’t.  Hospitals, similarly worried about bad publicity and liability, discouraged revealing mistakes to patients.

Ironically, instead of preventing litigation, the secrecy fostered it.  Patients who couldn’t get answers from their providers turned to lawyers for help. Once lawyers were involved, things became complicated and adversarial, and it was a short step to full blown litigation.

The secrecy compromised patient care and safety.  Providers who could not admit to an error had a difficult time mitigating it.  Hospitals that hid errors did not have the information they needed to prevent the mistakes from happening again.

Providers suffered as the unrecognized victims of their own errors.  Secrecy meant that providers received no support in the aftermath of the event.  Emotionally damaged and professionally shaken, their ability to treat patients and conduct themselves personally and professionally was diminished.

The Case for Disclosure

The arguments in favor of disclosure range from the ethical to the practical.  The following are just some of the reasons that the medical establishment is turning to disclosure when a mistake occurs:

Disclosure is the right thing to do

Patients and their families have a right to know what happened, and they have the right to know the implications of the mistake.  A patient who knows about the mistake can obtain appropriate treatment to correct any problems the mistake caused.  Disclosure also prevents the patient from worrying needlessly about other possible causes of those problems.

Disclosure is the ethical thing to do

The American College of Physicians and the American Medical Association both state that ethics requires physicians to disclose medical errors to patients.  As the AMA has explained:

“It is a fundamental ethical requirement that a physician should at all times deal honestly and openly with patients.  Patients have a right to know their past and present medical status and to be free of any mistaken beliefs concerning their conditions. Situations occasionally occur in which a patient suffers significant medical complications that may have resulted from the physician’s mistake or judgment.  In these situations, the physician is ethically required to inform the patient of all the facts necessary to ensure understanding of what has occurred.  Only through full disclosure is a patient able to make informed decisions regarding future medical care.”

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