Silber Tomas J, Hilliard Mary Anne
Pediatric Ethics Program, Division of Adolescent Medicine, Children's National Medical Center, USA.
Adolesc Med State Art Rev. 2011 Aug;22(2):289-300, x-xi.
This article describes iatrogenic events, giving examples that range from individual error to systemic malfunctions. It then goes on to analyze individual and system responsibilities in the disclosure of iatrogenic events. A discussion follows on the physician's responsibility, professional integrity, "duty to warn", and transparency as they relate to error disclosure, including an examination of the role of apology and repair in the setting of iatrogenesis. It concludes by considering the moral and legal operational implications of iatrogenic events and the building of a culture of safety.
本文描述了医源性事件，并给出了从个体失误到系统故障等一系列示例。接着，文章分析了在披露医源性事件时个体和系统应承担的责任。随后展开了关于医生责任、职业操守、“警告义务”以及与错误披露相关的透明度的讨论，其中包括审视道歉和补救在医源性发生背景下所起的作用。文章最后思考了医源性事件的道德和法律操作影响以及安全文化的构建。
