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Medical Errors: Should Doctors Always Fess Up?

From the Medscape Medical Ethics article entitled “‘Some Worms Are Best Left In The Can’: Should You Hide Medical Errors?“:

Consequences aside, from a strictly ethical perspective, if a patient doesn’t realize that his physician made a mistake, should the physician fess up?

Before you jump to conclusions (as I did), look at the article’s three parts. It’s about a survey. The title is on the inflammatory side; the article is a window into physicians’ views. The introduction continues:

Evidence of the complex prisms through which physicians view these issues was apparent in the replies to four questions asked in Medscape’s exclusive ethics survey. More than 10,000 physicians responded to the survey in 2010.

Subheads:

— Mistakes that don’t harm patients. “Are there times when it’s acceptable to cover up or avoid revealing a mistake if that mistake would not cause harm to the patient?” Sixty percent said “no;” the others split between “yes” and “it depends.”

  • I personally can understand this note from a survey respondent: “If there is a mistake that would have no medical effect but would cause extreme, uncalled-for anxiety, then yes,” especially since I know people (some elders, some young) who would indeed freak out, out of proportion. But, that’s a big judgment call.
  • I have a harder time accepting this comment: “Why shake the patient’s trust in the doctor for something that is irrelevant?” Irrelevant is a big judgment call, and I’d be really concerned about the natural human tendency to minimize the probable impact of a mistake — especially if a provider thinks it’s all about maintaining a patient’s trust, even when the topic is their own error.

— Mistakes that might harm patients. Ninety five percent said “no;” some still said “yes!” One commented: “If the mistake has not progressed to harmfulness, then it’s essentially a non-issue. Treatment correction takes place and you move on.” Another says if there hasn’t been harm yet, “I think a ‘wait and see’ approach is okay.” Read more »

*This blog post was originally published at e-Patients.net*

When Doctors Make Mistakes: About Humanness And Perfection

The best part of doctoring is its humanness. Machines can’t do it — not even Apple products.

But that’s the worst part, too. Since humans practice medicine, there will be “medical errors.” And when doctors err, people — not spreadsheets or profits — are hurt. That’s the rub. Like any endeavor, the greater the reward the greater the risk.  Those cards were put on the table in medical school.

“Don’t want mistakes? Don’t do anything. Don’t make any decisions. Don’t do any procedures. Then, there will be no errors,”  the grey-haired, Swiss-born cardiac surgeon counseled me many years ago after an imperfect ablation.

The headline was about a doctor’s error. It was a doozy. But for me, the story belies the headline. A Boston Globe reporter called a surgeon’s public admission of performing a wrong operation “an unusual display of openness.” I would call it something else: Breathtaking. Unprecedented. Courageous. Read more »

*This blog post was originally published at Dr John M*

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