Disclosing Adverse Events to Patients
The rationale for, and recommended approaches to, disclosing adverse events to patients are examined on the basis of the experience of the Veterans Health Administration (VHA). The VHA’s National Ethics Committee endorses a general policy requiring the routine disclosure of adverse events to patient...
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Veröffentlicht in: | Joint Commission journal on quality and patient safety 2005-01, Vol.31 (1), p.5-12 |
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container_title | Joint Commission journal on quality and patient safety |
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creator | Cantor, Michael D. Barach, Paul Derse, Arthur Maklan, Claire W. Wlody, Ginger Schafer Fox, Ellen |
description | The rationale for, and recommended approaches to, disclosing adverse events to patients are examined on the basis of the experience of the Veterans Health Administration (VHA). The VHA’s National Ethics Committee endorses a general policy requiring the routine disclosure of adverse events to patients and offers practical recommendations for implementation.
Disclosure is required when the adverse event (1) has a perceptible effect on the patient that was not discussed in advance as a known risk; (2) necessitates a change in the patient’s care; (3) potentially poses an important risk to the patient’s future health, even if that risk is extremely small; (4) involves providing a treatment or procedure without the patient’s consent. From an ethical perspective, disclosure is required and should not be limited to cases in which the injury is obvious or severe. Disclosure of near misses is also discretionary but is advisable at times. In general, disclosure by a clinician involved in the patient’s care is appropriate.
Although a variety of psychological and cultural factors may make clinicians and organizations reluctant to disclose adverse events to patients, the arguments favoring routine disclosure are compelling. Organizations should develop clear policies supporting disclosure and should create supportive environments that enable clinicians to meet their ethical obligations to disclose adverse events to patients and families. |
doi_str_mv | 10.1016/S1553-7250(05)31002-6 |
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Disclosure is required when the adverse event (1) has a perceptible effect on the patient that was not discussed in advance as a known risk; (2) necessitates a change in the patient’s care; (3) potentially poses an important risk to the patient’s future health, even if that risk is extremely small; (4) involves providing a treatment or procedure without the patient’s consent. From an ethical perspective, disclosure is required and should not be limited to cases in which the injury is obvious or severe. Disclosure of near misses is also discretionary but is advisable at times. In general, disclosure by a clinician involved in the patient’s care is appropriate.
Although a variety of psychological and cultural factors may make clinicians and organizations reluctant to disclose adverse events to patients, the arguments favoring routine disclosure are compelling. Organizations should develop clear policies supporting disclosure and should create supportive environments that enable clinicians to meet their ethical obligations to disclose adverse events to patients and families.</description><identifier>ISSN: 1553-7250</identifier><identifier>EISSN: 1938-131X</identifier><identifier>DOI: 10.1016/S1553-7250(05)31002-6</identifier><identifier>PMID: 15691205</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Bioethics ; Family ; Humans ; Patients - psychology ; Physician-Patient Relations ; Truth Disclosure - ethics</subject><ispartof>Joint Commission journal on quality and patient safety, 2005-01, Vol.31 (1), p.5-12</ispartof><rights>2005 Joint Commission on Accreditation of Healthcare Organizations</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c278t-4b85d61c64a3c55eaa9ba8ffeb7c33e71f6a0b4f870c7e2295509857fefab72f3</citedby><cites>FETCH-LOGICAL-c278t-4b85d61c64a3c55eaa9ba8ffeb7c33e71f6a0b4f870c7e2295509857fefab72f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15691205$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cantor, Michael D.</creatorcontrib><creatorcontrib>Barach, Paul</creatorcontrib><creatorcontrib>Derse, Arthur</creatorcontrib><creatorcontrib>Maklan, Claire W.</creatorcontrib><creatorcontrib>Wlody, Ginger Schafer</creatorcontrib><creatorcontrib>Fox, Ellen</creatorcontrib><title>Disclosing Adverse Events to Patients</title><title>Joint Commission journal on quality and patient safety</title><addtitle>Jt Comm J Qual Patient Saf</addtitle><description>The rationale for, and recommended approaches to, disclosing adverse events to patients are examined on the basis of the experience of the Veterans Health Administration (VHA). The VHA’s National Ethics Committee endorses a general policy requiring the routine disclosure of adverse events to patients and offers practical recommendations for implementation.
Disclosure is required when the adverse event (1) has a perceptible effect on the patient that was not discussed in advance as a known risk; (2) necessitates a change in the patient’s care; (3) potentially poses an important risk to the patient’s future health, even if that risk is extremely small; (4) involves providing a treatment or procedure without the patient’s consent. From an ethical perspective, disclosure is required and should not be limited to cases in which the injury is obvious or severe. Disclosure of near misses is also discretionary but is advisable at times. In general, disclosure by a clinician involved in the patient’s care is appropriate.
Although a variety of psychological and cultural factors may make clinicians and organizations reluctant to disclose adverse events to patients, the arguments favoring routine disclosure are compelling. Organizations should develop clear policies supporting disclosure and should create supportive environments that enable clinicians to meet their ethical obligations to disclose adverse events to patients and families.</description><subject>Bioethics</subject><subject>Family</subject><subject>Humans</subject><subject>Patients - psychology</subject><subject>Physician-Patient Relations</subject><subject>Truth Disclosure - ethics</subject><issn>1553-7250</issn><issn>1938-131X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtKAzEUhoMotlYfQZmNoovRk2SSzKxKqfUCBQUV3IVM5kRGpp2aTAu-velFXLo6Z_H95_IRckrhmgKVNy9UCJ4qJuASxBWnACyVe6RPC56nlNP3_dj_Ij1yFMInAJeyyA9JjwpZUAaiT85v62CbNtTzj2RUrdAHTCYrnHch6drk2XT1uj8mB840AU92dUDe7iav44d0-nT_OB5NU8tU3qVZmYtKUiszw60QaExRmtw5LJXlHBV10kCZuVyBVchYIQQUuVAOnSkVc3xALrZzF779WmLo9Cyeh01j5tgug5YqA8o4RFBsQevbEDw6vfD1zPhvTUGv_eiNH71-XoPQGz9axtzZbsGynGH1l9oJicBwC2B8c1Wj18FGBRar2qPtdNXW_6z4AVMDc_k</recordid><startdate>200501</startdate><enddate>200501</enddate><creator>Cantor, Michael D.</creator><creator>Barach, Paul</creator><creator>Derse, Arthur</creator><creator>Maklan, Claire W.</creator><creator>Wlody, Ginger Schafer</creator><creator>Fox, Ellen</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200501</creationdate><title>Disclosing Adverse Events to Patients</title><author>Cantor, Michael D. ; Barach, Paul ; Derse, Arthur ; Maklan, Claire W. ; Wlody, Ginger Schafer ; Fox, Ellen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c278t-4b85d61c64a3c55eaa9ba8ffeb7c33e71f6a0b4f870c7e2295509857fefab72f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Bioethics</topic><topic>Family</topic><topic>Humans</topic><topic>Patients - psychology</topic><topic>Physician-Patient Relations</topic><topic>Truth Disclosure - ethics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cantor, Michael D.</creatorcontrib><creatorcontrib>Barach, Paul</creatorcontrib><creatorcontrib>Derse, Arthur</creatorcontrib><creatorcontrib>Maklan, Claire W.</creatorcontrib><creatorcontrib>Wlody, Ginger Schafer</creatorcontrib><creatorcontrib>Fox, Ellen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Joint Commission journal on quality and patient safety</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cantor, Michael D.</au><au>Barach, Paul</au><au>Derse, Arthur</au><au>Maklan, Claire W.</au><au>Wlody, Ginger Schafer</au><au>Fox, Ellen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disclosing Adverse Events to Patients</atitle><jtitle>Joint Commission journal on quality and patient safety</jtitle><addtitle>Jt Comm J Qual Patient Saf</addtitle><date>2005-01</date><risdate>2005</risdate><volume>31</volume><issue>1</issue><spage>5</spage><epage>12</epage><pages>5-12</pages><issn>1553-7250</issn><eissn>1938-131X</eissn><abstract>The rationale for, and recommended approaches to, disclosing adverse events to patients are examined on the basis of the experience of the Veterans Health Administration (VHA). The VHA’s National Ethics Committee endorses a general policy requiring the routine disclosure of adverse events to patients and offers practical recommendations for implementation.
Disclosure is required when the adverse event (1) has a perceptible effect on the patient that was not discussed in advance as a known risk; (2) necessitates a change in the patient’s care; (3) potentially poses an important risk to the patient’s future health, even if that risk is extremely small; (4) involves providing a treatment or procedure without the patient’s consent. From an ethical perspective, disclosure is required and should not be limited to cases in which the injury is obvious or severe. Disclosure of near misses is also discretionary but is advisable at times. In general, disclosure by a clinician involved in the patient’s care is appropriate.
Although a variety of psychological and cultural factors may make clinicians and organizations reluctant to disclose adverse events to patients, the arguments favoring routine disclosure are compelling. Organizations should develop clear policies supporting disclosure and should create supportive environments that enable clinicians to meet their ethical obligations to disclose adverse events to patients and families.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>15691205</pmid><doi>10.1016/S1553-7250(05)31002-6</doi><tpages>8</tpages></addata></record> |
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issn | 1553-7250 1938-131X |
language | eng |
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source | MEDLINE; Alma/SFX Local Collection |
subjects | Bioethics Family Humans Patients - psychology Physician-Patient Relations Truth Disclosure - ethics |
title | Disclosing Adverse Events to Patients |
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