Bioethics Blogs

Enlisting Patients to Reduce Medical Errors

by Jennifer P. Cohen

Two recent reports on patient safety reinforce a compelling yet fairly obvious claim: doctors can reduce medical error by enlisting patients as participants in that process. Such a participation would mean more frank, proactive disclosure by healthcare professionals of the risks of medical error to patients, but by doing so, patients themselves may improve the chances of error-free care.  

Medical error made headlines this summer when a team at Johns Hopkins University claimed that 250,000 deaths per year are attributable to medical error.[i] If this claim is true,[ii] medical error would be the third leading cause of death in the United States, surpassed only by heart disease and cancer. A recent piece in JAMA explained that it is difficult to measure the magnitude of this issue because “there is no comprehensive, nationwide system for reporting or capturing all types of medical errors.”[iii] Even defining what constitutes medical errors is controversial. A 2006 report by the Institute of Medicine (IOM) concluded that “there are at least 1.5 million preventable [adverse drug events] that occur in the United States each year.”[iv] Should these events be counted as “errors”? Although there is still debate regarding how to define, quantify, and regulate this problem, all stakeholders agree that medical errors need to be reduced.

Much of the literature surrounding disclosure of error to patients, including the AMA’s Code of Ethics, is premised on three concerns: the ethical duty related to the patient’s autonomy, i.e., full disclosure of an error allows a patient “to make informed decisions regarding future medical care,”[v] the maintenance of trust in the doctor-patient relationship, and the reduction of legal liability.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.