Open disclosure: the only approach to medical error

• medical error
• open disclosure

The open, honest, and timely disclosure of medical error to patients should be, as Americans say, a “no brainer”. It is ethically, morally, and professionally expected of clinicians.1–3 It is clearly the right thing for patients who frequently say that, when things go wrong with their health care, what they need most is disclosure, an apology, and information about what happened and how it can be prevented from happening again.4

Clinical staff might feel that open disclosure is either too difficult to deliver or labour under the perception that, by doing this, they will increase the risk of litigation. But being honest with patients about errors and mistakes is the right thing for doctors, other clinical staff, and the hospital involved. Open and truthful discussion with the patient is the first stage in promoting and fostering an environment and culture that, through honest discussion, encourages the learning needed to improve systems and thus reduce medical error. Doctors and other clinical staff who are not used to such an approach to discussing errors will need support as such discussions are difficult. But once an error has been acknowledged, discussed, and acted upon, clinical teams can get on with their job of treating the sick.

This all sounds so obvious, particularly to a reporter like me who, during 25 years in journalism, has frequently interviewed patients who have suffered from the health care they have received. But, traditionally, the decision about whether or not to disclose information about an error when it has taken place has largely been left to individuals. Traditions die hard and, while many individual clinicians undoubtedly do deal with such matters openly and honestly, it is clear from public statements of many …