Telling patients the truth: a systems approach to disclosing adverse events
- Correspondence to: Dr M D Cantor, VHA National Center for Ethics (10AE), VACO, 810 Vermont Ave, N W Washington, DC 20420, USA;
The best way to improve disclosure of adverse events to patients and their families is to create a system for overseeing disclosure that is an integral part of the healthcare organisation's patient safety programme
The best way to improve disclosure of adverse events (where the term “adverse event” means injury caused by the provision of health care rather than the patient's illness, whether or not the event resulted from a clearly identifiable error or mistake) to patients and their families is to create a system for overseeing disclosure that is an integral part of a healthcare organisation's patient safety programme. Cultural, legal, regulatory, and financial barriers prevent clinicians and healthcare organisations from disclosing adverse events,1–3 despite the ethical obligations of clinicians and healthcare organisations to do so.4–7 Applying a systematic continuous quality improvement model to disclosure of adverse events like the one proposed by Liang8 in this issue of QSHC can help to overcome barriers to disclosure.
Effective disclosure of adverse events requires commitment to honesty and openness even when telling the truth may lead to loss of reputation, legal liability, or regulatory scrutiny. For clinicians the professional responsibilities of telling the truth and patient advocacy support disclosure of adverse events.6, 7 From an organisational perspective, successful disclosure systems require a willingness to put the interests of patients …