Health care institutions must decide whether to inform the patient of a medical error. The barriers to disclosure are an aversion to admitting errors, a concern about implicating other practitioners, and a fear of lawsuits and liability. However, admission of medical errors is the ethical thing to do and may be required by law. When examined, the barriers to such disclosures have little merit, and, in fact, lawsuits and liability may actually be reduced by informing the patient of medical errors. (...) Therefore, a health care institution should implement a written policy providing for disclosure of medical errors, using a process such as that outlined in the article. (shrink)

The Institute of Medicine (IOM) published To Err is Human: Building a Safer Health System in November 1999. The report focused public attention on the errors that occur within the medical system that cause death and harm to patients. It outlined a series of changes for health care that are aimed at reducing these errors by 50 percent over the next five years. This paper examines the problem of medical mistakes historically. It documents how legal, scientific, and medical trends during (...) the years 1890Ð1934 intersected to effect the reporting of mistakes in the subspecialty of neurosurgery. At the start of this time frame, mistakes were reported openly in journal articles as an educational tool. By its end, however, mistakes had gone ÒundergroundÓ and were buried amid a more objective, scientific reporting system. Using this historical perspective as a baseline, the paper concludes by re-examining the IOMÕs suggestions for change and comments on what they mean for the culture of medicine. (shrink)