5 - ethics

a preventable adverse effect of care

that is considered a serious public health problem.

What is a medical error?

false

In health care, it is uncommon that patients are exposed to harmful risks. ✅❌

true

In health care, it is not uncommon that patients are exposed to harmful risks. ✅❌

true

Some risks are predictable, at least at a level of probability, and informed consent is obtained. ✅❌

false

risks, such as those occurring because of medical errors (MEs) are usually predictable, and an informed consent can be obtained. ✅❌

true

Other risks, such as those occurring because of medical errors (MEs) are usually unpredictable, and an informed consent cannot be obtained. ✅❌

true

MEs may not always cause harm. ✅❌

false

MEs always cause harm. ✅❌

1. patients’ rights

2. issues of regulation, trust, and finance for the patient and for medical hospitals.

To what are medical errors ethically related?

between 5 - 10%

What is the estimated overall frequency of medical errors?

1. Errors of omission — أخطاء الإغفال

   • a result of actions not taken.

2. Errors of commission — أخطاء الارتكاب

   • result of the wrong action taken.

What are the two major types of medical errors?

Errors of commission

“administering a medication to which a patient has a known allergy”

this is an example of what type of MEs?

Errors of omission

“not strapping a patient into a wheelchair."

this is an example of what type of MEs?

Errors of commission

not labeling a laboratory specimen that is subsequently attributed to the wrong patient.

an event that under slightly different circumstances could have been an accident

What is a near miss in healthcare?

• it was detected and corrected in time

• the patient was just lucky.

Why might a near miss not result in harm?

• Reporting the ME to the healthcare system

• disclosing it to the patient

What actions should be taken when a medical error occurs?

Because reporting a ME is vital for quality and safety improvement.

Why is reporting a medical error important?

1. Promote public trust

2. Prevent further harm to a patient and to other patients

3. Respect personal autonomy

4. Support principle of justice

5. Improve the safety of medical practice

6. Be able to trust the physicians and the system

Why should medical errors be disclosed?

1. Patient autonomy

2. Justice: Patients need their rights and right to compensation التعويض

3. Truth-telling

4. Confidentiality

5. The relationship between a physician when he makes a disclosure to the patient must be transparent شفافة

What ethical issues are related to medical error disclosure?

1. may weaken efforts to improve the safety of medical practice in general.

2. If HCPs are unable to be honest with patients or families regarding the harmful event, they are unlikely to be entirely straightforward in the reporting of an incident to the appropriate authorities within a healthcare setting.

3. block efforts to identify the faults and weaknesses in the healthcare processes and procedures.

What are the consequences of non-disclosure of medical errors?

1. full disclosure of all the errors that result in harm

2. what happened and why

3. what the implications are

4. how the problem occurred

5. how to prevent it.

What do patients want when medical errors result in harm?

1. at the right time, when the patient is medically stable enough to absorb the information,

2. in the right setting

3. A physician should take the lead in disclosing error(s) to patients and their families.

When and where should medical error disclosure take place? and who should take the lead in disclosing error(s) to patients and their families?

1. disclose should be quickly, or as soon as possible

2. offer physical or psychological support (and financial)

How should healthcare providers disclose their medical errors?

true

Healthcare providers who witness a colleague disclosing an error are more likely to disclose their own errors in the future. ✅❌

1. Promote a safety-focused culture instead of blame or punishment.

2. View errors as challenges and improve healthcare systems.

3. Engage all team members in ensuring patient and staff safety.

How to Prevent Medical Errors?