Disclosure of Medical Errors: Ethical Considerations for the Development of a Facility Policy and Organizational Culture Change
The Institute of Medicine report, To Err Is Human: Building a Safer Health System, has spurred public concern over hospitals' ability to deliver safe care. The health care industry continues to struggle to address these concerns. These efforts have driven the growing expectation that health care practitioners or systems disclose unanticipated outcomes to patients and family members. Although the tort system has been cited as an impediment to medical error disclosure, some organizations and systems have successfully implemented policies calling for full disclosure of errors and unanticipated outcomes. However, most organizations have yet to develop policies concerning error disclosure. This article provides an overview of error disclosure and a model framework for an error disclosure policy. The ethical principle of respect for patient autonomy is emphasized as the driving force in developing an institutional disclosure policy and changing the organizational culture to one that supports development and implementation of such a policy.
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- "These can be translated into what one could term the ethics of the organization and can either contribute to or help prevent errors. A presentation given at Georgetown University ethics conference likened organizational ethics and healthcare as dual systems that would undergo systems changes, one simultaneously affecting the other (Henry, 2005). However, regardless of the healthcare error terminology or philosophy employed, when nurses act outside the boundaries of the law and nursing profession, it is expected that they will be disciplined (Johnstone & Kanitsaki, 2005). "
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ABSTRACT: A theory of lying is presented. A lie is to believe one thing and to express another. The liar must be aware that the belief
and statement are different. On this new definition: A lie is not the same as making a false statement. A lie is not the same
as not telling the objective truth. A lie in itself is neither good nor bad, but just a contradiction between belief and statement.
There are consequences of lying: We gain faulty information on which to base decisions. We fail to understand what or how
the liar really thinks and feels which is especially important in medicine. Communication is undermined as well as relationships,
which are based on communication. Trust is undermined. Lying promotes more lying and encourages others to lie. A lie (or truth)
may benefit all in the short run, but not in the long run, or vice versa. We may not realize or be able to know in advance
the harmful consequences that even the smallest lie may have.
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ABSTRACT: Medical methods and decisions are often based on traditional, culture-bound practices, rather than on sound, critical thinking
considering consequences. As medical language and practice are influenced by the culture, culture must be critically examined.
Decision-making is based on language. It mainly involves the making of causal statements, which are phrased in language and
can therefore be no more precise than the language used. Frequent causes of irrational medical thinking and decision-making
are analyzed especially fallacies from the claim of certainty where only can be probability and medical and societal un-culture
of dealing with mistakes. Five levels of decision-making in medicine are presented: 1. Medical, 2. Ethical, 3. Interdisciplinary,
4. Philosophy of Medicine, and 5. Philosophy in general.
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