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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
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Abstract

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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