Abstract
This essay reviews and defines avoidable medical error, malpractice and complication. The relevant ethical principles pertaining to unanticipated medical outcomes are identified. In light of these principles I critically review the moral culpability of the agents in each circumstance and the resulting obligations to patients, their families, and the health care system in general. While I touch on some legal implications, a full discussion of legal obligations and liability issues is beyond the scope of this paper.
Similar content being viewed by others
References
Banja, J. D. (2008). Does medical error disclosure violate the medical malpractice insurance cooperation clause? Agency for Healthcare Research and Quality. Accessed October 31, 2008. Available: http://www.ahrq.giv/qual/advances/.
Berlinger, N. (2005). After harm: Medical error and the ethics of forgiveness. Baltimore, MD: The Johns Hopkins University Press.
Clinton, H. R., & Obama, B. (2006). Making patient safety the centerpiece of medical liability reform. The New England Journal of Medicine, 354(21), 2205–2208.
Council on Ethical and Judicial Affairs. (2007). Code of medical ethics. Chicago, IL: American Medical Association.
Denham, C. R. (2007). Trust: The 5 rights of the second victim. Journal of Patient Safety, 3(2), 107–119.
DeVita, M. A. (2001). Honestly, do we need a policy on truth? Kennedy Institute of Ethics Journal, 11(2), 157–164.
Gallagher, T. H., Studdert, D., & Levinson, W. (2007). Disclosing harmful medical errors to patients. The New England Journal of Medicine, 356(26), 2713–2719.
Gallagher, T. H., Waterman, A. D., Ebers, A. G., Fraser, V. J., & Levinson, W. (2003). Patients’ and physicians’ attitudes regarding the disclosure of medical errors. The Journal of the American Medical Association, 289(8), 1001–1007.
Hoffman, D. N. (2005). The medical malpractice insurance crisis, again. The Hastings Center Report, 35(2), 15–19.
Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (1999). To err is human: Building a safer health system. Washington, DC: National Academy Press.
Kraman, S. S., & Hamm, G. (1999). Risk management: Extreme honesty may be the best policy. Annals of Internal Medicine, 131(12), 963–967.
Lazare, A. (2006). Apology in medical practice: An emerging clinical skill. The Journal of the American Medical Association, 296(11), 1401–1404.
Massachusetts Coalition for the Prevention of Medical Errors. (2008). When things go wrong: Responding to adverse events. A consensus statement of the Harvard Hospitals. Accessed October 10, 2008. Available: www.macoalition.org.
Maxfield, D., Grenny, J., McMillan, R., Patterson, K., & Switzler, A. (2008). Silence kills: The seven crucial conversations for healthcare. Accessed October 10, 2008. Available: http://www.silencekills.com.
May, T., & Aulisio, M. P. (2001). Medical malpractice, mistake prevention, and compensation. Kennedy Institute of Ethics Journal, 11(2), 135–146.
Mazor, K. M., Simon, S. R., Yood, R. A., Martinson, B. C., Gunter, M. J., Reed, G. W., et al. (2004). Health plan members’ views about disclosure of medical errors. Annals of Internal Medicine, 140(6), 409–418.
National Quality Forum. (2006). Safe practices for better healthcare 2006 update. Washington, DC: National Quality Forum.
Pellegrino, E. D. (2004). Prevention of medical error: Where professional and organizational ethics meet. In V. A. Sharpe (Ed.), Accountability: Patient safety and policy reform. Washington, DC: Georgetown University Press.
Robbennolt, J. K. (2003). Apologies and legal settlement: An empirical examination. Michigan Law Review, 102(460), 460–515.
Snyder, L., Leffler, C., for the Ethics and Human Rights Committee, & American College of Physicians. (2005). Ethics manual: Fifth edition. Annals of Internal Medicine, 142(7), 560–582.
Studdert, D. M., Mello, M. M., Gawande, A. A., Gandhi, T. K., Kachalia, A., Yoon, C., et al. (2006). Claims, errors, and compensation payments in medical malpractice litigation. The New England Journal of Medicine, 354(19), 2024–2033.
Taft, L. (2007). Disclosure danger: The overlooked case of the cooperation clause. Harvard Health Policy Review, 8(2), 46–53.
Thurman, A. E. (2001). Institutional responses to medical mistakes: Ethical and legal perspectives. Kennedy Institute of Ethics Journal, 11(2), 147–156.
University of Pittsburg Medical Center-Presbyterian Hospital. (2001). Guidelines for disclosure and discussion of conditions and events with patients, families, and guardians. Kennedy Institute of Ethics Journal, 11(2), 165–168.
West, C. P., Huschka, M. M., Novotny, P. J., Sloan, J. A., Kolars, J. C., Habermann, T. M., et al. (2006). Association of perceived medical errors with resident distress and empathy: A prospective longitudinal study. The Journal of the American Medical Association, 296(9), 1071–1078.
Winslade, W., & McKinney, E. B. (2006). To tell or not to tell disclosing medical error. Journal of Law, Medicine, and Ethics, 34(4), 813–816.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zientek, D.M. Medical Error, Malpractice and Complications: A Moral Geography. HEC Forum 22, 145–157 (2010). https://doi.org/10.1007/s10730-010-9130-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10730-010-9130-9