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HEC Forum

, Volume 22, Issue 2, pp 145–157 | Cite as

Medical Error, Malpractice and Complications: A Moral Geography

  • David M. Zientek
Article

Abstract

This essay reviews and defines avoidable medical error, malpractice and complication. The relevant ethical principles pertaining to unanticipated medical outcomes are identified. In light of these principles I critically review the moral culpability of the agents in each circumstance and the resulting obligations to patients, their families, and the health care system in general. While I touch on some legal implications, a full discussion of legal obligations and liability issues is beyond the scope of this paper.

Keywords

Medical error Malpractice Preventable error Adverse event 

References

  1. Banja, J. D. (2008). Does medical error disclosure violate the medical malpractice insurance cooperation clause? Agency for Healthcare Research and Quality. Accessed October 31, 2008. Available: http://www.ahrq.giv/qual/advances/.
  2. Berlinger, N. (2005). After harm: Medical error and the ethics of forgiveness. Baltimore, MD: The Johns Hopkins University Press.Google Scholar
  3. Clinton, H. R., & Obama, B. (2006). Making patient safety the centerpiece of medical liability reform. The New England Journal of Medicine, 354(21), 2205–2208.CrossRefGoogle Scholar
  4. Council on Ethical and Judicial Affairs. (2007). Code of medical ethics. Chicago, IL: American Medical Association.Google Scholar
  5. Denham, C. R. (2007). Trust: The 5 rights of the second victim. Journal of Patient Safety, 3(2), 107–119.CrossRefGoogle Scholar
  6. DeVita, M. A. (2001). Honestly, do we need a policy on truth? Kennedy Institute of Ethics Journal, 11(2), 157–164.CrossRefGoogle Scholar
  7. Gallagher, T. H., Studdert, D., & Levinson, W. (2007). Disclosing harmful medical errors to patients. The New England Journal of Medicine, 356(26), 2713–2719.CrossRefGoogle Scholar
  8. Gallagher, T. H., Waterman, A. D., Ebers, A. G., Fraser, V. J., & Levinson, W. (2003). Patients’ and physicians’ attitudes regarding the disclosure of medical errors. The Journal of the American Medical Association, 289(8), 1001–1007.CrossRefGoogle Scholar
  9. Hoffman, D. N. (2005). The medical malpractice insurance crisis, again. The Hastings Center Report, 35(2), 15–19.CrossRefGoogle Scholar
  10. Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (1999). To err is human: Building a safer health system. Washington, DC: National Academy Press.Google Scholar
  11. Kraman, S. S., & Hamm, G. (1999). Risk management: Extreme honesty may be the best policy. Annals of Internal Medicine, 131(12), 963–967.Google Scholar
  12. Lazare, A. (2006). Apology in medical practice: An emerging clinical skill. The Journal of the American Medical Association, 296(11), 1401–1404.CrossRefGoogle Scholar
  13. Massachusetts Coalition for the Prevention of Medical Errors. (2008). When things go wrong: Responding to adverse events. A consensus statement of the Harvard Hospitals. Accessed October 10, 2008. Available: www.macoalition.org.
  14. Maxfield, D., Grenny, J., McMillan, R., Patterson, K., & Switzler, A. (2008). Silence kills: The seven crucial conversations for healthcare. Accessed October 10, 2008. Available: http://www.silencekills.com.
  15. May, T., & Aulisio, M. P. (2001). Medical malpractice, mistake prevention, and compensation. Kennedy Institute of Ethics Journal, 11(2), 135–146.CrossRefGoogle Scholar
  16. Mazor, K. M., Simon, S. R., Yood, R. A., Martinson, B. C., Gunter, M. J., Reed, G. W., et al. (2004). Health plan members’ views about disclosure of medical errors. Annals of Internal Medicine, 140(6), 409–418.Google Scholar
  17. National Quality Forum. (2006). Safe practices for better healthcare 2006 update. Washington, DC: National Quality Forum.Google Scholar
  18. Pellegrino, E. D. (2004). Prevention of medical error: Where professional and organizational ethics meet. In V. A. Sharpe (Ed.), Accountability: Patient safety and policy reform. Washington, DC: Georgetown University Press.Google Scholar
  19. Robbennolt, J. K. (2003). Apologies and legal settlement: An empirical examination. Michigan Law Review, 102(460), 460–515.CrossRefGoogle Scholar
  20. Snyder, L., Leffler, C., for the Ethics and Human Rights Committee, & American College of Physicians. (2005). Ethics manual: Fifth edition. Annals of Internal Medicine, 142(7), 560–582.Google Scholar
  21. Studdert, D. M., Mello, M. M., Gawande, A. A., Gandhi, T. K., Kachalia, A., Yoon, C., et al. (2006). Claims, errors, and compensation payments in medical malpractice litigation. The New England Journal of Medicine, 354(19), 2024–2033.CrossRefGoogle Scholar
  22. Taft, L. (2007). Disclosure danger: The overlooked case of the cooperation clause. Harvard Health Policy Review, 8(2), 46–53.Google Scholar
  23. Thurman, A. E. (2001). Institutional responses to medical mistakes: Ethical and legal perspectives. Kennedy Institute of Ethics Journal, 11(2), 147–156.CrossRefGoogle Scholar
  24. University of Pittsburg Medical Center-Presbyterian Hospital. (2001). Guidelines for disclosure and discussion of conditions and events with patients, families, and guardians. Kennedy Institute of Ethics Journal, 11(2), 165–168.Google Scholar
  25. West, C. P., Huschka, M. M., Novotny, P. J., Sloan, J. A., Kolars, J. C., Habermann, T. M., et al. (2006). Association of perceived medical errors with resident distress and empathy: A prospective longitudinal study. The Journal of the American Medical Association, 296(9), 1071–1078.CrossRefGoogle Scholar
  26. Winslade, W., & McKinney, E. B. (2006). To tell or not to tell disclosing medical error. Journal of Law, Medicine, and Ethics, 34(4), 813–816.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  1. 1.Seton Medical CenterAustinUSA
  2. 2.The Center for Clinical BioethicsGeorgetown UniversityWashingtonUSA
  3. 3.AustinUSA

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