Confronting medical errors in oncology and disclosing them to cancer patients.

摘要

Medical errors are common, and physicians face increasing pressure to fully disclose unanticipated outcomes and medical errors to patients. From an ethical perspective, disclosure is the right thing to do and is wholly consistent with the fiduciary model of the asymmetric physician-patient relationship, in which the patient, vulnerable due to illness, places trust in the expertise and person of the physician. When medical errors occur, the physician-patient relationship is fundamentally tested, and when physicians fail to offer an apology or explanation, patients often perceive a violation not only of their safety, but also of their trust. The issue of which events merit disclosure is still under debate. The most widely disseminated disclosure standard, from the Joint Commission on Accreditation of Healthcare Organizations, requires that patients be informed about all outcomes of care including "unanticipated outcomes," as defined in the current terminology (Table I).