Disclosing adverse events to patients. Jt Comm J Qual Patient Saf 2005 Jan;31(1):5-12
Date
02/05/2005Pubmed ID
15691205DOI
10.1016/s1553-7250(05)31002-6Scopus ID
2-s2.0-15944423968 (requires institutional sign-in at Scopus site) 37 CitationsAbstract
BACKGROUND: The rationale for, and recommended approaches to, disclosing adverse events to patients are examined on the basis of the experience of the Veterans Health Administration (VHA). The VHA's National Ethics Committee endorses a general policy requiring the routine disclosure of adverse events to patients and offers practical recommendations for implementation.
PRACTICAL APPROACHES TO DISCLOSING ADVERSE EVENTS: Disclosure is required when the adverse event (1) has a perceptible effect on the patient that was not discussed in advance as a known risk; (2) necessitates a change in the patient's care; (3) potentially poses an important risk to the patient's future health, even if that risk is extremely small; (4) involves providing a treatment or procedure without the patient's consent. From an ethical perspective, disclosure is required and should not be limited to cases in which the injury is obvious or severe. Disclosure of near misses is also discretionary but is advisable at times. In general, disclosure by a clinician involved in the patient's care is appropriate.
CONCLUSION: Although a variety of psychological and cultural factors may make clinicians and organizations reluctant to disclose adverse events to patients, the arguments favoring routine disclosure are compelling. Organizations should develop clear policies supporting disclosure and should create supportive environments that enable clinicians to meet their ethical obligations to disclose adverse events to patients and families.
Author List
Cantor MD, Barach P, Derse A, Maklan CW, Wlody GS, Fox EAuthor
Arthur R. Derse MD, JD Director, Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
FamilyHumans
Patients
Physician-Patient Relations
Truth Disclosure
