Patient SafetyMedical mistakes and frivolous suitsIsn't the chief theme of patient-safety advocates that health workers will share information in a supportive, non-punitive environment. Are they not saying that rewarding reporting adverse events and near misses can elicit such information, as though ego, embarrassment, peer ostracism, loss of reputation, and concerns about lawsuits and license revocation and damaged careers can be overcome by tweaking the environment? Ethicist Nancy Berlinger says that even the systems in medicine that promote "confession, repentance, and forgiveness" are limited to the professional side of medicine and do not ensure justice for patients [in the book Accountability]. Legal scholar and physician William M. Sage says that relying on peer review and informal sanctions are inadequate substitutes for public surveillance and accountability [in the book Accountability]. Patient abuse will never be reported by the abusers. Patient safety initiatives that do not acknowledge and address the darkest side of medicine will not overcome the obstacles overwhelming the reporting of even simple, well-meaning errors. |
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