In matters of medical error and complications, patients and families overwhelmingly want to be informed. Most patients want providers to disclose if a complication or an error has occurred, and want to be informed of any possible adverse outcomes from the event. Most want to be informed immediately following an event and expect an investigation when the cause is not readily identified. When the event is due to an error, patients and families want honest disclosure and a sincere apology from those responsible. Afterward, they want continued emotional and psychological support, and they expect efforts to identify and correct the cause. Historically, physicians and institutions have been slow to fully disclose errors, especially if they were preventable. Patients have frequently not been provided with the support they require and often have felt frightened and alienated. The immediate effects of medical mistakes can be devastating, but the subsequent emotional, personal, and relational consequences can be very distressing. Silence, shame, guilt, and fractured trust disrupt the therapeutic relationship and leave patients, families, and caregivers to suffer alone.