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Truthfulness in the Physician-Patient Relationship

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Case-Based Teaching Guide: Truthfulness in the Physician-Patient Relationship – Physician Fallibility, Medical Error and Disclosure

Mistakes are an inevitable part of medical practice. While many of these errors are trivial, some result in harm to patients.

Acknowledging fallibility in the face of a culture that expects infallibility can be difficult. Physicians may be concerned that admission of an error will result in loss of trust by their patients, loss of esteem from colleagues and potential legal liability.

Fortunately, there is a growing body of literature recognizing that humans will inevitably make mistakes, and systems must be designed to identify and prevent human error.

Even given the emphasis on a systems approach to error, mistakes will occur and physicians will face potential barriers to disclosing their mistakes. Truthfulness and trustworthiness are considered important moral attributes of physicians, and both would require that physicians disclose mistakes to patients. But many questions remain: What constitutes an error requiring disclosure? How can one best disclose errors to a family?

These materials explore the ethical issues that arise when a physician makes a mistake in patient care. Participants will discuss the obligation to disclose errors to families, identify what kinds of mistakes must be disclosed to families, recognize barriers to disclosure and explore strategies for informing families that an error has occurred and what steps have been taken to prevent or minimize harm.

Read the Instructor’s Guide or Student’s Guide.

This teaching guide was developed by Douglas J. Opel, MD, senior fellow, Clinical Bioethics, and Douglas S. Diekema, MD, MPH, director of education, Treuman Katz Center for Pediatric Bioethics, Seattle Children's Hospital.

In addition to the copyright notice set forth in the link below, permission to display, cache and print unlimited copies of the Case-Based Teaching Guides referred to on this page is hereby granted, solely for educational purposes, without charge (other than charges solely to cover the costs of copying), and without alteration of the Materials in any way.

1. Instructor's Guide2. Student's Guide3. Case Discussion

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