Confessional Approach to Disclosure of Medical Error

Author(s):  
Jordan Mason

Abstract Recent literature on the ethics of medical error disclosure acknowledges the feelings of injustice, confusion, and grief patients and their families experience as a result of medical error. Substantially less literature acknowledges the emotional and relational discomfort of the physicians responsible or suggests a meaningful way forward. To address these concerns more fully, I propose a model of medical error disclosure that mirrors the theological and sacramental technique of confession. I use Aquinas’ description of moral acts to show that all medical errors are evil, and some accidental medical errors constitute venial sins; all sin and evil should be confessed. As Aquinas urges confession for sins, here I argue that confession is necessary to restore physicians to the community and to provide a sense of absolution. Even mistakes for which physicians are not morally culpable ought to be confessed in order to heal the physician–patient relationship and to address feelings of professional distress. This paper utilizes an Episcopal theology of confession that affirms verbal admission and responsibility-taking as freeing and relationally restoring acts, arguing that a confessional stance toward medical error both leads to better outcomes in physician–patient relationships and is more compassionate toward physicians who err.

2019 ◽  
Vol 28 (4) ◽  
pp. 255-266
Author(s):  
Vitor Mendonça ◽  
Thomas Gallagher ◽  
Nicholas Hendryx

Abstract The objective of this study is to better understand the tensions involved in the fear of making an error due to the harm and risk this would pose to those involved. This is a qualitative study based on the narratives of the experiences lived by ten acting physicians in the state of São Paulo, Brazil. The concept and characterization of errors were discussed, as well as the fear of making an error, the near misses or error in itself, how to deal with errors and what to do to avoid them. The analysis indicates an excessive pressure in the medical profession for error-free practices, with a well-established physician-patient relationship to facilitate the management of medical errors. The error occurs but the lack of information and discussion often leads to its concealment due to fear of possible judgment by society or peers. The establishment of programs that encourage appropriate medical conduct in the event of an error requires coherent answers for humanization in Brazilian medical science.


2021 ◽  
Vol 6 (12) ◽  
pp. 204-217
Author(s):  
Mustafa SAMANCI

Balint groups were put forward by Michael Balint, who studied the physician-patient relationship with its deep dimensions in the 1950s. The Balint group method consists of case presentations and general discussions that emphasize the emotional content of physician-patient relationships following the case presentation. One of the aims of establishing Balint groups is to help health professionals and medical students develop empathy skills to reduce communication difficulties between people. Today, worldwide widely used in a manner Approaches of Balint Group, was not given sufficient importance in Turkey. Today, although many scientific studies have been published about Balint groups, there is not any work published in Turkey. The purpose of this study is to discuss the results of some studies about the Balint Group Method and to explain the definition, content, and application of this method in family medicine. It is known that the Balint Group Method contributes greatly to the increase of physicians' empathy levels and to decrease their burnout levels. Nowadays, due to the Covid-19 pandemic, healthcare workers have quite tiring and difficult days and their burnout levels are increasing considerably. According to the results of the study, the application of the Balint Group Method by physicians in Covid-19 and the following period will contribute to better physician-patient relations as well as reduce the burnout levels of physicians. In Turkey, the introduction of the Balint Group Method, implementation, and inclusion in educational curricula are recommended. Also, it is recommended that physicians who have experienced the Balint Group Method contribute to the increase of the physician-patient relationship by making these experiences into scientific publications, sharing the results with the literature. As a result of the literature review, the implementation of this method in the virtual environment during the pandemic period and its spread throughout the world will make the application of this method even easier.


Author(s):  
C.Christopher Hook ◽  
Paul S. Mueller

Medicine is first and foremost a relationship. It is the coming together of one individual, the patient, who is ill or has specific needs and a second individual, the physician, whose goal is to help the patient and who possesses a unique set of knowledge and skills to pursue that goal. Because medicine is fundamentally a relationship, it is at heart an ethical endeavor. Indeed, the physician-patient relationship is a fiduciary relationship; physicians have knowledge, skills, and powers that patients do not have. In turn, patients-who are often sick and vulnerable-must trust that physicians act in their patients' best interests. As a result, physicians have a long and rich history of creating oaths and codes that provide ethical norms and frameworks to support and protect physician-patient relationships. Medical ethics consists of a set of principles and systematic methods that attempt to guide physicians on how they ought to act in their relationships with patients and others and how to resolve moral problems that arise in the care of patients.


2006 ◽  
Author(s):  
Luigi Anolli ◽  
Fabrizia Mantovani ◽  
Alessia Agliati ◽  
Olivia Realdon ◽  
Valentino Zurloni ◽  
...  

1987 ◽  
Vol 12 (1) ◽  
pp. 55-97 ◽  
Author(s):  
Fran Carnerie

AbstractMany individuals develop a temporary state of cognitive and emotional impairment after being diagnosed with catastrophic illness. Thus, when crucial decisions about medical treatment are required, they are unable to assimilate information; or worse, the legal need to be informed can rival a psychological desire to not be informed. The Canadian informed consent doctrine is unresponsive to crisis and clinically impracticable, and so paradoxically compromises the integrity and autonomy it was designed to protect. Many aspects of the physician-patient relationship and clinical setting also undermine the philosophical values enshrined in this doctrine. This further jeopardizes the individual's integrity. The Article explores proposals for change such as delaying the informing and consenting, improving the concept of consent, and improving the role of the physician.


2021 ◽  
pp. bmjspcare-2020-002764
Author(s):  
Catherine Owusuaa ◽  
Irene van Beelen ◽  
Agnes van der Heide ◽  
Carin C D van der Rijt

ObjectivesAccurate assessment that a patient is in the last phase of life is a prerequisite for timely initiation of palliative care in patients with a life-limiting disease, such as advanced cancer or advanced organ failure. Several palliative care quality standards recommend the surprise question (SQ) to identify those patients. Little is known about physicians’ views on identifying and disclosing the last phase of life of patients with different illness trajectories.MethodsData from two focus groups were analysed using thematic analysis with a phenomenological approach.ResultsFifteen medical specialists and general practitioners participated. Participants thought prediction of patients’ last phase of life, i.e. expected death within 1 year, is important. They seemed to find that prediction is more difficult in patients with advanced organ failure compared with cancer. The SQ was considered a useful prognostic tool; its use is facilitated by its simplicity but hampered by its subjective character. The medical specialist was considered mainly responsible for prognosticating and gradually disclosing the last phase. Participants’ reluctance to such disclosure was related to uncertainty around prognostication, concerns about depriving patients of hope, affecting the physician–patient relationship, or a lack of time or availability of palliative care services.ConclusionsPhysicians consider the assessment of patients’ last phase of life important and support use of the SQ in patients with different illness trajectories. However, barriers in disclosing expected death are prognostic uncertainty, possible deprivation of hope, physician–patient relationship, and lack of time or palliative care services. Future studies should examine patients’ preferences for those discussions.


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