Communicating with Patients About Adverse Medical Events: If, When, and How to Say “I’m Sorry”
Adverse medical events can result a variety of factors including practitioner error and systems failure. The process by which such events are communicated to patients by health care providers is called disclosure. Disclosure of medical error is currently considered an ethical and professional obligation of healthcare providers. In many jurisdictions, “apology laws” protect disclosure and apology from being used against the physician in malpractice litigation. This chapter discusses when disclosure is appropriate, the timing of disclosure, what should be disclosed, the process of disclosure, the legal consequences of disclosure, caring for the caregiver, as well as how to handle disclosure for minors, multiple victims of harm, and those lacking capacity. Paradoxically, studies have revealed a reduction in malpractice litigation following institution of disclosure and compensation programs. Hypothetical case scenarios exemplifying a combination of systems and practitioner error resulting in patient harm and a “near miss” causing no harm are analyzed.
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