{"id":8195,"date":"2011-01-12T12:53:12","date_gmt":"2011-01-12T16:53:12","guid":{"rendered":"http:\/\/pmedicine.org\/epatients\/?p=8195"},"modified":"2011-01-12T13:33:56","modified_gmt":"2011-01-12T17:33:56","slug":"some-worms-are-best-left-in-the-can-should-you-hide-medical-errors","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2011\/01\/some-worms-are-best-left-in-the-can-should-you-hide-medical-errors.html","title":{"rendered":"&#8216;Some Worms Are Best Left in the Can&#8217; &#8211; Should You Hide Medical Errors?"},"content":{"rendered":"<p>From <a href=\"http:\/\/www.medscape.com\/viewarticle\/735033?src=mp&amp;spon=43\" target=\"_blank\">Medscape Medical Ethics<\/a>:<\/p>\n<blockquote><p>Consequences aside, from a strictly ethical perspective, if a patient doesn&#8217;t realize that his physician made a mistake, should the physician fess\u00a0up?&#8230;<\/p><\/blockquote>\n<p>Before you jump to conclusions (as I did!), look at the article&#8217;s three parts. It&#8217;s about a survey. The title is on the inflammatory side; the article is a window into physician views. The introduction continues:<\/p>\n<blockquote><p>Evidence of the complex prisms through which physicians view these issues was apparent in the replies to four questions asked in Medscape&#8217;s exclusive ethics survey. More than 10,000 physicians responded to the survey in 2010.<\/p><\/blockquote>\n<p>Subheads:<!--more--><\/p>\n<ul>\n<li><strong>Mistakes that don&#8217;t harm patients.<\/strong> &#8220;Are there times when it&#8217;s acceptable to cover up or avoid revealing a mistake if that mistake\u00a0<em>would not<\/em> cause harm to the patient?&#8221; 60% said no; the others split between yes and &#8220;it depends.&#8221;\n<ul>\n<li>I personally can understand this note from a survey respondent: &#8220;If there is a mistake that would have no medical effect but would cause extreme, uncalled-for anxiety, then yes,&#8221; especially since I know people (some elders, some young) who would indeed freak out, out of proportion. But, that&#8217;s a big judgment call.<\/li>\n<li>I have a harder time accepting this comment: &#8220;Why shake the patient&#8217;s trust in the doctor for something that is irrelevant?&#8221; Irrelevant is a <em>big <\/em>judgment call, and I&#8217;d be really concerned about the natural human tendency to minimize the probable impact of a mistake &#8230; especially if a provider thinks it&#8217;s all about maintaining a patient&#8217;s trust, even when the topic is their own error.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Mistakes that might harm patients.<\/strong> 95% said no; some still said yes! One commented, &#8220;If the mistake has not progressed to harmfulness, then it&#8217;s essentially a non-issue. Treatment correction takes place and you move on.&#8221; Another says if there hasn&#8217;t been harm <em>yet, <\/em>&#8220;I think a &#8216;wait and see&#8217; approach is okay.&#8221;<\/li>\n<li><strong>Is it self-serving to let sleeping dogs lie?<\/strong> Ethicist and pediatrician Professor Margaret R. Moon, MD, MPH\u00a0&#8220;agrees that when a mistake has the potential to cause harm, disclosure is the way to go. A &#8220;let sleeping dogs lie&#8221; strategy, or the aforementioned &#8220;wait and see&#8221; approach may be in the physician&#8217;s best interests, she says, but it&#8217;s rarely in the patient&#8217;s best interests &#8212; especially if it was a clinical error, because clinical errors affect the patient&#8217;s body.&#8221;<\/li>\n<\/ul>\n<p>There will naturally be some selection bias &#8211; the above gives us no insight into the views of physicians who wouldn&#8217;t <em>touch <\/em>such a survey. But, what do you think?<\/p>\n<p><em>(The survey included a final section on patient privacy, e.g. casual hallway conversations, but that&#8217;s outside the scope of this post.)<\/em><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>From Medscape Medical Ethics: Consequences aside, from a strictly ethical perspective, if a patient doesn&#8217;t realize that his physician made a mistake, should the physician fess\u00a0up?&#8230; Before you jump to [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"give_campaign_id":0,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[281,5,59],"tags":[],"coauthors":[],"class_list":["post-8195","post","type-post","status-publish","format-standard","hentry","category-ethics","category-ptdoc-co-care","category-policy-issues"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>&#039;Some Worms Are Best Left in the Can&#039; - Should You Hide Medical Errors? 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