Nonmaleficence Nonmaleficence means to do no harm. This principle is directly tied to the healthcare providers duty to protect the patient’s safety at all times in all circumstances (Bait Amer, 2019). Born out of the Hippocratic Oath, this principle dictates that the medical professional does not cause injury to patients. It is without a doubt that medical errors do cause injury or harm to patients, and it is also obvious that a therapist or any other medical professional does not randomly try to harm a patient. However, dismissing a seemingly insignificant symptom as unimportant could lead to an error Beneficence is the professional duty to do or produce good (Bait Amer, 2019). In public health, the governing ethical theory is utilitarianism, which can be defined as doing the greatest good for the largest number of people. Beneficence includes what constitutes a good outcome for a patient without infringing on the patient's autonomy or letting the patient come to serious harm. Saintly and heroic beneficence and benevolence are at the extreme end of a continuum of beneficent conduct and commitment which adds up to not being “beyond” duty but rather the “beginning” of duty. Autonomy Autonomy recognizes that an individual who is competent has the right to make an informed choice about medical treatment (Bait Amer, 2019). This choice must be made without coercion or undue influences from others. The principle of beneficence requires that medical professionals do that which is considered good, or in the best interests of the person for whom they are providing care. An ethical dilemma is created when autonomy and beneficence are at two opposite poles. The question remains: Is it ethical to in the future. Beneficence
overrule a patient’s' preferences? Most would agree that a patient's health comes first. But the controversy is when the medical professional confuses what is good for the patient with the patient’s perceived outcome of the situation—which may or may not be in the patient’s best interest. Paternalism Paternalism refers more to an attitude or a policy stemming from the hierarchic pattern of a family where there is a male figurehead (the father, pater in Latin). A paternal figure provides for the needs of a group without giving the group individual rights or responsibilities. Weak paternalism infers that the medical professional is protecting the patient when the patient is unable to make decisions due to problems such as depression or the influence of medications. On the other hand, strong paternalism involves interactions intended to benefit a person despite the fact that the person’s risky choices and actions are informed, voluntary, and autonomous. Privacy and confidentiality Privacy and confidentiality relate to privacy, which belongs to each person and cannot be taken away from that person. Confidentiality means that the information shared with the medical professional will not be unnecessarily shared with others (Bait Amer, 2019). Sharing a patient’s private information with others without the patient’s permission infringes upon the confidentiality agreement between that patient and his or her doctor. A confidentiality agreement is imposed to ensure that information will be shared with others only on a need-to-know basis. Justice Justice means giving each person what they are due. It can be measured in terms of fairness, equality, need, or any other criterion that is material to the justice decision (Bait Amer, 2019). Justice often focuses on equal access to care and on allotting resources equally. Reasons for medical professional nondisclosure There is a fear of confession, which could be appropriate concerning the shame and blame that persists within the healthcare system. The withholding of information could exacerbate the patients’ upset emotions. The medical professional must always keep in mind that the patient has rights as well as responsibilities when it comes to their healthcare (Edwin, 2009). A medical professional is also affected by a medical error. It may be difficult facing the fact that they are responsible for causing harm. This is totally opposite from the oath the medical professional took to do no harm. Another reason for a medical professional to seek nondisclosure in the event of a medical error is the fear of retaliation from the patient. If that is the case, perhaps it may be advantageous to take a look down the road at the consequences when the medical error is uncovered. The patient’s fury would be greater and rightly so, because they were not only harmed but then lied to by omission. A medical professional may very well fear the length and breadth of negative media bias. This is a real-life fear because if the media hears of it, the medical professional will be maligned, which really is not fair either. However, the media bias will be greater and last longer if the medical error is concealed and then it comes out later. It is obvious that to disclose is the better choice in the long run. The patient will be more tolerant of the adverse medical event if the medical professional uses it as a time to create a dialog they are not scared to have.
DISCLOSURE OF A MEDICAL ERROR
Disclosure of errors has been haphazardly studied with varying published approaches and vague standards. Because of this lack of research, creating an effective prevention plan can be challenging. However, doctors must take the lead in disclosing an error in an objective and narrative way to patients and their families. Patients and their families must be their own advocates by dictating the pace and scope of discussions concerning treatment. Unvoiced concerns that patients may have must be attended to and answered in the best possible manner by the medical professional. It may be tempting for the medical professional to act defensively or evasively and react to the patient if they are accusatory. The medical professional can defuse this reaction by remaining calm and steady. Failing to provide the patient with the needed information about an error could impair the patients’ clinical decision-making going forward, diminish patient confidence in the medical professional, and may also increase the likelihood of a lawsuit. Physicians have said that they fear medical errors on a daily basis because of the possibility of lawsuits, loss of patient trust, and the damage to the physician’s reputation. Some professionals find it difficult to admit they have made a mistake. When a medical error does occur, blame cannot be placed on one individual to assume full responsibility because there is usually a team of providers. In any case, patients would always like to hear an apology with an explanation of the error directly, honestly and compassionately delivered in an expeditious manner from the medical professional.
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Book Code: MFL1225B
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