Abstract
Evaluating the efficacy and accuracy of clinical reasoning and distinguishing between complications and medical errors is a difficult task. However, it seems to be an even more difficult task to provide models for systematically reporting and reducing those errors through improvements in the entire web of healthcare delivery.The report “To Err Is Human: Building a Safer Health System” published in 1999 highlighted the importance of patient safety and proposed some interventions. However, a follow up by the authors of the report in 2005 stated that progress in matters of safer care delivery and improved communications was slow. The interventions proposed include “pay for performance” incentives, implementation of electronic health records, diffusion of safe practices and team training for full disclosure of medical errors to patients following injury.As patients increasingly are consumers, customers and regulatory actors in their own healthcare, it becomes harder to hide medical mistakes in clinical encounters. Explaining why and how the medical error happened, giving informed assurance that the mistake will be avoided in the future and offering sincere apologies to patients and families are skills that need to be taught to medical students as early as the undergraduate level. Those skills are very difficult to teach in the university environment and would be learned more effectively with years of experience. However, structured educational programs focusing in the necessity and components of a good medical error disclosure would improve awareness in the importance of an effective and honest doctor–patient relationship.In this review paper, we compare international literature and examples from Turkey with regard to disclosure of medical errors. The Turkish literature on malpractice cases is rich and most of them point out that medical errors occur because of heavy workloads, insufficient infrastructure and lack of high quality medical education. However, the lack of any papers on medical disclosure to patients in Turkey seems to point out to the big communication gap between patients and doctors, among other reasons. We will address some of the reasons for such lack in Turkey and present recommendations about how to disclose medical errors to patients such as implementation of electronic medical error disclosure systems, education and training, and legislation.
Highlights
Interview and survey-based research works conducted among specialists and trainees from a variety of medical disciplines point to the fact that inadequate disclosure of medical errors is a universal, specialty–overarching problem.[1,2,3,4,5]In 1983, Neil McIntyre and Karl Popper declared thatMistakes occur in medicine as in other walks of life'
Distinguishing between medical errors and complications is a di±cult task, and this problem seems to be connected to the inherent uncertainty in matters of healing: How can medical standardization be reconciled with the big diversity of bodies and pathologies? How can doctors standardize diagnosis and therapy, in the midst of Disclosure of Medical Errors variation in work conditions, training and education, and experience and personal background?
The results revealed a gap between surgeons' intentions and actual practices, which authors relate to the paternalistic traits in medical culture specically, and the Persian–Shia culture in general.[23]
Summary
Interview and survey-based research works conducted among specialists and trainees from a variety of medical disciplines point to the fact that inadequate disclosure of medical errors is a universal, specialty–overarching problem.[1,2,3,4,5]. In 1983, Neil McIntyre and Karl Popper declared thatMistakes occur in medicine as in other walks of life' They emphasized the necessity of a new medical ethics, which teaches doctors to recognize and analyze their own and their colleagues' mistakes.[6] Later, in the early 90s, Leape and Brennan of Harvard University showed the magnitude of medical mistakes in the U. It proposed the denition of error as \the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim".9. Disclosure of medical errors to patients and their families is considered an ethical duty of the physicians and will become inevitable as there is more emphasis in safer and more patient-centered care.[3,10]
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