Reflection on Adverse Event Disclosure in the Postsurgical Hospital Context

Abstract

Surgeons are most likely to fill the role of communicating adverse outcomes following surgery and nearly two-thirds are faced with conveying the news of death during surgery. However, surgeon-patient communication research focuses primarily on presurgery issues such as recommendations and decision making rather than improvement of postsurgical communication. Several studies have examined the consequences of avoiding adverse event disclosure, but as yet, there is no conceptual framework for understanding why these interactions are difficult. In this reflection, we propose that 3 dimensions (relational distance, information-poor environment, and physical harm to patients) distinguish the adverse event context from other physician-patient encounters. We conclude by offering recommendations for educational and research efforts, drawing attention to empathy in the surgical context and barriers to empathic disclosure more broadly.