Disclosure of Medical Errors: Ethical Considerations for the Development of a Facility Policy and Organizational Culture Change

George Mason University, Fairfax, Virginia, USA.
Policy Politics & Nursing Practice 06/2005; 6(2):127-34. DOI: 10.1177/1527154404272611
Source: PubMed


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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