Medical errors are an unavoidable part of medicine practice and present a considerable threat to patients’ safety. Improper handling of clinical workflow processes, healthcare professionals, and information systems causes medical errors. Release of medical errors to clients and their family members provides an impetus for litigation (Bonney, 2014). The setting up of right ethical and moral standards in the implementation of measures to correct medical errors disclosures cannot be ignored.
Several ethical and moral issues beleaguer the healthcare industry due to medical errors. Morality is the social conventions on what is held as right or wrong. On the other hand, ethics is the systematic and theoretical perception of moral life. In the healthcare industry, ethical and moral issues mainly revolve around the concepts of Beneficence and Non-maleficence, Justice, Autonomy and Right to Self-Determination, Disclosure and Right to Knowledge, and Veracity.
The fear of legal liability or litigation often creates barriers to physicians’ disclosure and apology for medical errors. In particular, medical students and other healthcare staff struggle in making decisions on whether to disclose medical errors or remain silent especially when the disclosure require violation of the general medical hierarchy for error disclosure. The principle of respondeat superior further complicates medical disclosure dilemma by holding the attending physicians finally responsible for the entire decisions regarding a patient and absolving everybody else involved in the physicians’ procedure from any error. Physicians also contend with the decision of disclosing medical errors committed by fellow physicians.
Alternatives for Addressing the Dilemma and their Implications
Whistleblowing is often recommended as a remedy for ethical dilemma surrounding disclosure of medical error in the healthcare industry. However, both the victim of the allegations and the accuser or whistleblower might suffer if the allegations are confirmed. Whistleblowers might also become unpopular, and in worst cases they might be shunned and even dismissed from their institutions. Subsequently, physicians usually discuss their peers’ errors among themselves, but rarely talks about them with patients. Whistleblowing is hence not an ideal remedy for solving ethical dilemma about disclosure of medical errors in the healthcare industry.
Offering an apology to the patient for the harm inflicted by the medical error is also recommended as a remedy to concerns about disclosure of such errors. An apology to the patient is regarded as one of the ethical obligations of medicine practice. Honest and full disclosure of errors is also viewed as ideally consistent with the trust and mutual respect expectations of patients on their physicians (Kalantri, 2003). However, physicians find it difficult to balance between their ethical responsibilities to parents and their fear of litigation or legal liabilities posed by error disclosure. Apologizing is tantamount to the acknowledgement of errors and hence may give the patient or family members the ground for opening criminal charges against the physicians for the harm inflicted on the patient as a result of the errors.
Most Appropriate Alternative and Describe its Implementation
Remediation of medical error is recommended as the ideal remedy for handling ethical dilemma on disclosure of errors in the healthcare industry. Remediation of errors goes beyond whistleblowing and apologizing by acknowledging the complexity of the context in which decisions on the disclosure of medical errors are made. Basically, remediation of errors in healthcare industry involves a delicate balancing of patient’s interests including respect for his/her wellbeing and autonomy, with the interests of healthcare profession in charge of the patient’s case. Professional interests include the recognition of the implication of disclosure on the patient-physician relationship. Disclosure of errors is not often the priority in the healthcare industry. Instead, the wellbeing of the patient as well as the patient-physician relationship is paramount. Thus, decisions on disclosure should be made in consideration of the patient’s well-being, the qualitative extent of the error and the implication of disclosure on the patient-physician relationship.
- Bonney, W. (2014). Medical errors: Moral and ethical considerations. Journal of Hospital Administration, 3(2), 80-88.
- Kalantri, S. P. (2003). Medical errors and ethics. Indian Journal of Anaesthesia,, 47(3), 174-175.