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Ethical problems in radiology: medical error and disclosure

Problemi etici in radiologia: errore medico e rivelazione dell’errore

  • Ethics/Etica
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Abstract

In radiological practice, as in any medical activity, errors are inevitable despite being foreseeable and preventable. The approach to managing medical error and relations with patients prompt the need for resolving the ethical dilemma arising from conflicting legitimate interests. The solution to this dilemma is particularly complex in an environment in which the tendency to sue physicians for civil liability or incriminate them for criminal liability appears to be particularly high. The disclosure of error is undeniably useful in raising patient awareness, reducing their suffering, improving the quality of care and limiting the consequences of the damage. There does not appear to be any evidence to suggest disclosure modifies the probability of litigation against the physician.

Riassunto

Nella pratica radiologica, come in qualsiasi attività medica, l’errore è inevitabile, anche se prevedibile e prevenibile. Le modalità di gestione dell’errore medico e le relazioni con i pazienti pongono la necessità di risolvere il dilemma etico che scaturisce dalla contrapposizione di interessi legittimi. La soluzione di tale dilemma è particolarmente complessa in un ambiente nel quale la tendenza a citare il medico per responsabilità civile o a incriminarlo penalmente appare oggettivamente elevata. La rivelazione dell’errore è certamente utile ad aumentare la consapevolezza del paziente, ridurne le sofferenze, migliorare la qualità dell’assistenza e limitare le conseguenze del danno. Non vi è evidenza che tale atto modifichi la probabilità che il medico sia sottoposto ad una azione giudiziaria.

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References/Bibliografia

  1. Kohn LT, Corrigan JM, Donaldson MS (eds) (2000) To err is human: building a safer health system. National Academy Press, Washington

    Google Scholar 

  2. Rajendran PR (2001) Ethical issues involved in disclosing medical errors. JAMA 286: 1078

    Article  CAS  PubMed  Google Scholar 

  3. Hayward RA, Hofer TP (2001) Estimating hospital deaths due to medical errors: preventability is in the eye of the reviewer. JAMA 286: 415–420

    Article  CAS  PubMed  Google Scholar 

  4. Thomas EJ, Petersen LA (2003) Measuring errors and adverse events in health care. J Gen Intern Med 18: 61–67

    Article  PubMed  Google Scholar 

  5. Brennan TA, Leape LL, Laird NM et al (2004) Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. Qual Saf Health Care 13: 145–152

    Article  CAS  PubMed  Google Scholar 

  6. de Vries EN, Ramrattan MA, Smorenburg SM et al (2008) The incidence and nature of in-hospital adverse events: a systematic review. Qual Saf Health Care 17: 216–223

    Article  PubMed  Google Scholar 

  7. Mc Donald CJ, Weiner M, Hui SL (2000) Deaths due to medical errors are exaggerated in Institute of Medicine Report. JAMA 284: 93–95

    Article  Google Scholar 

  8. Delbanco T, Bell SK (2007) Guilty, afraid, and alone-struggling with medical error. N Engl J Med 357: 1682–1683

    Article  CAS  PubMed  Google Scholar 

  9. West CP, Huschka MM, Novotny PJ et al (2006) Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA 296: 1071–1078

    Article  CAS  PubMed  Google Scholar 

  10. Fileni A, Magnavita N, Mammi F et al (2007) Malpractice stress syndrome in radiologists and radiotherapists. Perceived causes and consequences. Radiol Med 112: 1069–1084

    Article  CAS  PubMed  Google Scholar 

  11. Fileni A, Magnavita N (2006) A 12-year follow-up study of malpractice claims against radiologists in Italy. Radiol Med 111: 1009–1022

    Article  CAS  PubMed  Google Scholar 

  12. Fileni A, Magnavita N, Pescarini L (2009) Analysis of malpractice claims in mammography: a complex issue. Radiol Med 114: 636–644

    Article  CAS  PubMed  Google Scholar 

  13. Pitman AG (2006) Perceptual error and the culture of open disclosure in Australian radiology. Australasian Radiology 50: 206–211

    Article  CAS  PubMed  Google Scholar 

  14. Caldwell C, Seamone ER (2007) Excusable neglect in malpractice suits against radiologists: a proposed jury instruction to recognize the human condition. Ann Health Law 16: 43–77

    PubMed  Google Scholar 

  15. Raskin MM (2006) Survival strategies for radiology: some practical tips on how to reduce the risk of being sued and losing. J Am Coll Radiol 3: 689–693

    Article  PubMed  Google Scholar 

  16. Brenner RJ, Bartholomew L (2005) Communication errors in radiology: a liability cost analysis. J Am Coll Radiol 2: 428–431

    Article  PubMed  Google Scholar 

  17. Reiner BI, Knight N, Siegel EL (2007) Radiology reporting, past, present, and future: the radiologist’s perspective. J Am Coll Radiol 4: 313–319

    Article  PubMed  Google Scholar 

  18. Berlin L (2007) Communicating results of all radiologic examinations directly to patients: has the time come? AJR Am J Roentgenol 189: 1275–1282

    Article  PubMed  Google Scholar 

  19. Brenner RJ (1993) Mammography and malpractice litigation: current status, lessons and admonitions. AJR Am J Roentgenol 161: 931–935

    CAS  PubMed  Google Scholar 

  20. Berlin L, Berlin JW (1995) Malpractice and radiologists in Cook county, IL: trends in 20 years of litigation. AJR Am J Roentgenol 165: 781–788

    CAS  PubMed  Google Scholar 

  21. Fileni A, Magnavita N (1995) Malpractice lawsuits in Radiology - Comparison of the Italian and American situations. Radiology 197: 548–549

    CAS  PubMed  Google Scholar 

  22. Fileni A, Magnavita N (1996) Analisi delle denunce assicurative di responsabilità civile in Radiologia. Primi dati italiani. Radiol Med 91: 275–278

    CAS  PubMed  Google Scholar 

  23. Ferner RE, McDowell SE (2006) Doctors charged with manslaughter in the course of medical practice, 1795-2005: a literature review. J R Soc Med 99: 309–314

    Article  CAS  PubMed  Google Scholar 

  24. Pukk-Harenstam K, Ask J, Brommels M et al (2008) Analysis of 23364 patient-generated, physician-reviewed malpractice claims from a non-tort, blame-free, national patient insurance system: lessons learned from Sweden. Qual Saf Health Care 17: 259–263

    CAS  PubMed  Google Scholar 

  25. Gallagher TH, Studdert D, Levinson W (2007) Disclosing harmful medical errors to patients. N Engl J Med 356: 2713–2719

    Article  CAS  PubMed  Google Scholar 

  26. Berlinger N, Wu AW (2005) Subtracting insult from injury: addressing cultural expectations in the disclosure of medical error. J Med Ethics 31: 106–108

    Article  CAS  PubMed  Google Scholar 

  27. Kaldjian LC, Jones EW, Wu BJ et al (2008) Reporting medical errors to improve patient safety: a survey of physicians in teaching hospitals. Arch Intern Med 168: 40–46

    Article  PubMed  Google Scholar 

  28. Gallagher TH, Waterman AD, Ebers AG et al (2003) Patients’ and physicians’ attitudes regarding the disclosure of medical errors. JAMA 289: 1001–1007

    Article  PubMed  Google Scholar 

  29. Berlin L (2006) Will saying “I’m sorry” prevent a malpractice suit? AJR Am J Roentgenol 187: 10–15

    Article  PubMed  Google Scholar 

  30. Taft L (2005) Apology and medical mistake: opportunity or foil? Ann Health Law 14: 55–94

    Google Scholar 

  31. Hobgood C, Tamayo-Sarver JH, Elms A, Weiner B (2005) Parental preferences for error disclosure, reporting, and legal action after medical error in the care of their children. Pediatrics 116: 1276–1286

    Article  PubMed  Google Scholar 

  32. Berlin L (1999) Admitting mistakes. AJR Am J Roentgenol 172: 879–884

    CAS  PubMed  Google Scholar 

  33. Gebhardt DO (2003) Patient organisations should also establish databanks on medical complications. J Med Ethics 29: 115

    Article  CAS  PubMed  Google Scholar 

  34. Kraman SS, Hamm G (1999) Risk management: extreme honesty may be the best policy. Ann Intern Med 131: 963–967

    CAS  PubMed  Google Scholar 

  35. Mazor KM, Reed GW, Yood RA et al (2006) Disclosure of medical errors. What factors influence how patients respond? J Gen Intern Med 21: 704–710

    Article  PubMed  Google Scholar 

  36. Wusthoff CJ (2001) Medical mistakes and disclosure: the role of the medical student. JAMA 286: 1080–1081

    Article  CAS  PubMed  Google Scholar 

  37. Lee SK, Cowie SE (2001) Medical students and remediation of error. JAMA 286: 1082–1083

    Article  CAS  PubMed  Google Scholar 

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Correspondence to N. Magnavita.

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Magnavita, N., Magnavita, G., Fileni, A. et al. Ethical problems in radiology: medical error and disclosure. Radiol med 114, 1345–1355 (2009). https://doi.org/10.1007/s11547-009-0445-z

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  • DOI: https://doi.org/10.1007/s11547-009-0445-z

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