Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-28T02:06:24.119Z Has data issue: false hasContentIssue false
  • English
  • Français

Doctors' Duty to Disclose Error: A Deontological or Kantian Ethical Analysis

Published online by Cambridge University Press:  16 February 2016

Mark Bernstein  and
Barry Brown
Mark Bernstein*
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada Joint Center for Bioethics, University of Toronto, Toronto, Ontario, Canada
Barry Brown
Affiliation:
Department of Philosophy, University of Toronto, Toronto, Ontario, Canada Joint Center for Bioethics, University of Toronto, Toronto, Ontario, Canada
*
Department of Surgery, University of Toronto, Division of Neurosurgery, Toronto Western Hospital, 399 Bathurst Street, 4W451, Toronto, Ontario M5T2S8, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Medical (surgical) error is being talked about more openly and besides being the subject of retrospective reviews, is now the subject of prospective research. Disclosure of error has been a difficult issue because of fear of embarrassment for doctors in the eyes of their peers, and fear of punitive action by patients, consisting of medicolegal action and/or complaints to doctors'governing bodies. This paper examines physicians'and surgeons'duty to disclose error, from an ethical standpoint; specifically by applying the moral philosophical theory espoused by Immanuel Kant (ie. deontology). The purpose of this discourse is to apply moral philosophical analysis to a delicate but important issue which will be a matter all physicians and surgeons will have to confront, probably numerous times, in their professional careers.

Type
Review Article
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 2 , May 2004 , pp. 169 - 174
Copyright
Copyright © The Canadian Journal of Neurological 2004

References

1.LeBlang, TR. Disclosure of injury and illness: responsibilities in the physician-patient relationship. Law Med Health Care 1981; 9:47.CrossRefGoogle Scholar
2.Aubrey, ME. The error of our ways. Can Med Assoc J 2001; 165:270–271.Google ScholarPubMed
3.Bernstein, M, Hebert, PC, Etchells, E. Patient safety in neurosurgery: detection of errors, prevention of errors, and disclosure of errors. Neurosurgery Quarterly 2003; 13:125–137.CrossRefGoogle Scholar
4.Hebert, PC, Levin, AV, Robertson, G. Bioethics for clinicians: 23. Disclosure of medical error. Can Med Assoc J 2001; 164:509–513.Google ScholarPubMed
5.Kohn, LT, Corrigan, JM, Donaldson, MS (Eds). To Err is Human. Building a Safer Health System. Washington D.C.: National Academy Press, 2000.Google Scholar
6.Liang, BA. The adverse event of unaddressed medical error: identifying and filling the holes in the health-care and legal systems. J Law Med Ethics 2001; 29:346–368.CrossRefGoogle ScholarPubMed
7.Wu, AW, Cavanaugh, TA, McPhee, SJ, Lo, B, Micco, GP. To tell the truth: ethical and practical issues in disclosing medical mistakes to patients. J Gen Intern Med 1997; 12:770–775.CrossRefGoogle ScholarPubMed
8.Bernstein, M, Parrent, AG. Complications of CT-guided stereotactic biopsy of intra-axial brain lesions. J Neurosurg 1994; 81:165–168.CrossRefGoogle ScholarPubMed
9.Cabantog, A, Bernstein, M. Complications of first craniotomy for intra-axial brain tumor. Can J Neurol Sci 1994; 21:213–218.CrossRefGoogle Scholar
10.de Laval, MR, Carthey, J, Wright, DJ, et al. Human factors and cardiac surgery: a multicenter study. J Thor Cardiovasc Surg 2000; 119:661–672.CrossRefGoogle Scholar
11.Gawande, AA, Thomas, EJ, Zinner, MJ, Brennan, TA. The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Surgery 1999; 126:66–75.CrossRefGoogle ScholarPubMed
12.Leape, LL, Brennan, TA, Laird, N, et al. The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med 1991; 324:377–384.CrossRefGoogle ScholarPubMed
13.Bernstein, M, Massicotte E: Prospective error recording in surgery: a feasibility study in 500 neurosurgical cases. Evidence-Based Surgery 2003; 1:57–62.Google Scholar
14.Bentham, J. An Introduction to the Principles of Morals and Legislationq. Burns, JH, Hart, HLA (Eds). Oxford: Clarendon Press, 1970.Google Scholar
15.Mill, JS. The Collected Works of John Stuart Mill. To ronto: University of Toronto Press, 1969.Google Scholar
16.Kant, I. Practical Philosophy. Cambridge, New York, Melbourne: Cambridge University Press, 1996.Google Scholar
17.Kant, I. The Moral Law. Groundwork of the Metaphysic of Morals. Paton, HJ. London and New York: Routledge, 1948.Google Scholar
18.Gallagher, TH, Waterman, AD, Ebers, AG, Fraser, VJ, Levinson, W. Patients’ and physicians’ attitudes regarding the disclosure of medical errors. JAMA 2003; 289:1001–1007.CrossRefGoogle ScholarPubMed
19.Hobgood, C, Peck, CR, Gilbert, B, Chappell, K, Zou, B. Medical errors — what and when: what do patients want to know? Acad Emerg Med 2002; 9:1156–1161.CrossRefGoogle ScholarPubMed