Abstract
Patient safety and ethics are interrelated concepts. Clinical ethics is similar to other clinical practices and can be evaluated and improved using basic quality improvement principles. Distilling ethical issues clinically can be facilitated by identifying specific elements of safety and how they are affected by the ethical concerns. In addition, promoting patient safety rests on core ethical principles ubiquitous in medicine—the professional duties to provide benefit and prevent harm. Tying these ethical principles to quality and safety analysis has been a strong motivator in quality and safety improvement. Further, describing safety issues in terms of ethical responsibilities has the potential to motivate individual providers to improve quality and safety within their personal practice.
“Do not be ashamed of mistakes and thus make them crimes.”
Confucius
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Notes
- 1.
The term “clinical ethics” describes an area of practice that a provider may have special training in, or the skill set any provider uses in addressing ethical issues in say to day practice. Fully defining and describing the term is outside the scope of this chapter but further information can be found at sites like http://www.asbh.org/publications/content/core.html. Last accessed 22 Apr 2012.
- 2.
Several cases have addressed this issue. For an example of the legal reasoning see Bouvia v Superior Court, 179 Cal. App 3d 1127 (1986).
- 3.
An example of the implementation of New York state’s 2010 Family Healthcare Decisions Act in an academic medical center can be found at http://www.amc.edu/academic/bioethics/documents/AMC_FHCDA_Article.pdf. Accessed 13 Jul 2013.
- 4.
An early case, Wright v. Johns Hopkins Health Systems Corp., 353 Md. 568, 585–86 (1999), found no liability for unwanted resuscitation but there have been more legal challenges in other states and the claim is gaining favor in ethics and legal discussions of the issue.
- 5.
POLST.org describes the orders and summarizes which states have enacted formal POLST type laws. Available at http://www.polst.org. Accessed 13 Jul 2013.
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Egan, E.A. (2014). Clinical Ethics and Patient Safety. In: Agrawal, A. (eds) Patient Safety. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7419-7_6
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