Editing Medical error (section)

==== To patients ====
Gallagher et al. state that patients want "information about what happened, why the error happened, how the error's consequences will be mitigated, and how recurrences will be prevented."<ref name="pmid12597752">{{cite journal |vauthors=Gallagher TH, Waterman AD, Ebers AG, Fraser VJ, Levinson W |title=Patients' and physicians' attitudes regarding the disclosure of medical errors |journal=JAMA |volume=289 |issue=8 |pages=1001–7 |year=2003 |pmid=12597752 |doi=10.1001/jama.289.8.1001|doi-access=free }}</ref> Interviews with patients and families reported in a 2003 book by Rosemary Gibson and Janardan Prasad Singh, put forward that those who have been harmed by medical errors face a "wall of silence" and "want an acknowledgement" of the harm.<ref>{{cite book |author1=Rosemary Gibson |author2=Janardan Prasad Singh |title=Wall of Silence |year=2003 |publisher=Regnery |isbn=978-0-89526-112-0 |url=https://archive.org/details/wallofsilenceunt00gibs }}</ref> With honesty, "healing can begin not just for the patients and their families but also the doctors, nurses and others involved." In a line of experimental investigations, [[Annegret Hannawa]] et al. developed evidence-based disclosure guidelines under the scientific "Medical Error Disclosure Competence (MEDC)" framework.<ref name="annegrethannawa.com"/><ref name="pmid9436897">{{cite journal |last1=Wu |first1=Albert W. |last2=Cavanaugh |first2=Thomas A. |last3=McPhee |first3=Stephen J. |last4=Lo |first4=Bernard |last5=Micco |first5=Guy P. |title=To tell the truth |journal=Journal of General Internal Medicine |date=December 1997 |volume=12 |issue=12 |pages=770–775 |doi=10.1046/j.1525-1497.1997.07163.x |pmid=9436897 |pmc=1497204 }}</ref>

A review of studies examining patients' views on investigations of medical harm found commonalities in their expectations of the process. For example, many wanted reviews to be transparent, trustworthy, and person-centred to meet their needs. People wanted to be meaningfully involved in the process and to be treated with respect and empathy. Justice-seekers wanted an honest account of what happened, the circumstances leading up to it, and measures to ensure it does not happen again. Processes that, for example, involved people independent of the organisation responsible for harm gave investigations credibility.<ref>{{Cite journal |last1=Shaw |first1=Liz |last2=Lawal |first2=Hassanat M. |last3=Briscoe |first3=Simon |last4=Garside |first4=Ruth |last5=Thompson Coon |first5=Jo |last6=Rogers |first6=Morwenna |last7=Melendez-Torres |first7=G. J. |date=2023-12-01 |title=Patient, carer and family experiences of seeking redress and reconciliation following a life-changing event: Systematic review of qualitative evidence |journal=Health Expectations |language=en |volume=26 |issue=6 |pages=2127–2150 |doi=10.1111/hex.13820 |issn=1369-6513 |pmc=10632635 |pmid=37452516}}</ref><ref>{{Cite journal |date=10 January 2024 |title=How to improve investigations of medical harm |url=https://evidence.nihr.ac.uk/alert/how-to-improve-investigations-of-medical-harm/ |journal=NIHR Evidence |doi=10.3310/nihrevidence_61101 |s2cid=266946352 |access-date=January 12, 2024 |archive-date=January 12, 2024 |archive-url=https://web.archive.org/web/20240112160213/https://evidence.nihr.ac.uk/alert/how-to-improve-investigations-of-medical-harm/ |url-status=live |url-access=subscription }}</ref>

A 2005 study by [[Wendy Levinson]] of the [[University of Toronto]] showed surgeons discussing medical errors used the word "error" or "mistake" in only 57 percent of disclosure conversations and offered a verbal apology only 47 percent of the time.<ref>{{cite web | last=Kelly | first=Karen | year=2005 | url=http://www.news.utoronto.ca/bin6/051117-1824.asp | title=Study explores how physicians communicate mistakes | publisher=University of Toronto | access-date=2006-03-17 |archive-url = https://web.archive.org/web/20060322154328/http://www.news.utoronto.ca/bin6/051117-1824.asp <!-- Bot retrieved archive --> |archive-date = 2006-03-22}}</ref>

Patient disclosure is important in the medical error process. The current standard of practice at many hospitals is to disclose errors to patients when they occur. In the past, it was a common fear that disclosure to the patient would incite a [[Medical malpractice|malpractice]] lawsuit. Many physicians would not explain that an error had taken place, causing a lack of trust toward the healthcare community. In 2007, 34 states passed legislation that precludes any information from a physician's apology for a medical error from being used in malpractice court (even a full admission of fault).<ref>{{Cite web |url=http://psnet.ahrq.gov/primer.aspx?primerID=2 |title=Archived copy |access-date=April 25, 2009 |archive-date=September 6, 2015 |archive-url=https://web.archive.org/web/20150906053931/http://psnet.ahrq.gov/primer.aspx?primerID=2 |url-status=live }}</ref> This encourages physicians to acknowledge and explain mistakes to patients, keeping an open line of communication.

The American Medical Association's Council on Ethical and Judicial Affairs states in its ethics code:
:"Situations occasionally occur in which a patient suffers significant [[medical complication]]s that may have resulted from the physician's mistake or judgment. In these situations, the physician is ethically required to inform the patient of all facts necessary to ensure understanding of what has occurred. Concern regarding legal liability which might result following truthful disclosure should not affect the physician's honesty with a patient."

From the American College of Physicians Ethics Manual:<ref name="pmid15809467">{{cite journal |vauthors=Snyder L, Leffler C |title=Ethics manual: fifth edition |journal=Ann Intern Med |volume=142 |issue=7 |pages=560–82 |year=2005 |pmid=15809467 |last3=Ethics Human Rights Committee |doi=10.7326/0003-4819-142-7-200504050-00014|s2cid=53090205 }}</ref>
:"In addition, physicians should disclose to patients information about procedural or judgment errors made in the course of care if such information is material to the patient's well-being. Errors do not necessarily constitute improper, negligent, or unethical behavior, but failure to disclose them may."

However, "there appears to be a gap between physicians' attitudes and practices regarding error disclosure. Willingness to disclose errors was associated with higher training level and a variety of patient-centered attitudes, and it was not lessened by previous exposure to malpractice litigation".<ref name="pmid17473944">{{cite journal |vauthors=Kaldjian LC, Jones EW, Wu BJ, Forman-Hoffman VL, Levi BH, Rosenthal GE |title=Disclosing Medical Errors to Patients: Attitudes and Practices of Physicians and Trainees |journal=Journal of General Internal Medicine |volume=22 |issue=7 |pages=988–96 |year=2007 |pmid=17473944 |doi=10.1007/s11606-007-0227-z |pmc=2219725}}</ref> Hospital administrators may share these concerns.<ref name="pmid15769969">{{cite journal |vauthors=Weissman JS, Annas CL, Epstein AM, etal |title=Error reporting and disclosure systems: views from hospital leaders |journal=JAMA |volume=293 |issue=11 |pages=1359–66 |year=2005 |pmid=15769969 |doi=10.1001/jama.293.11.1359|doi-access=free }}</ref>

Consequently, in the [[United States]], many states have enacted laws excluding expressions of sympathy after accidents as proof of liability.

Disclosure may actually reduce malpractice payments.<ref name="pmid10610651">{{cite journal |vauthors=Wu AW |title=Handling hospital errors: is disclosure the best defense? |journal=Ann. Intern. Med. |volume=131 |issue=12 |pages=970–2 |year=1999 |pmid=10610651 |doi=10.7326/0003-4819-131-12-199912210-00012|s2cid=36889006 }}</ref><ref name="pmidWSJ">{{cite news |author=Zimmerman R |title=Doctors' New Tool To Fight Lawsuits: Saying 'I'm Sorry' |url=https://www.wsj.com/articles/SB108482777884713711 |work= The Wall Street Journal |page=A1 |date=May 18, 2004|archive-url=https://web.archive.org/web/20070823101409/http://www.mc.vanderbilt.edu/root/vumc.php?site=CPPA&doc=3270|archive-date=August 23, 2007}}</ref>

Reluctance to disclose medical errors to patients may also stem from [[psychological]] reasons. In his book, ''[[Medical Errors and Medical Narcissism]]'', John Banja defines "medical [[narcissism]]" as the need of health professionals to preserve their [[self-esteem]] leading to the compromise of error disclosure to patients.<ref>Banja, John, Medical Errors and Medical Narcissism, 2005</ref>