Bascuñán María Luz, Arriagada Ana María
Departamento de Bioética y Humanidades Médicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Hospital del Salvador, Chile.
Rev Med Chil. 2016 Sep;144(9):1185-1190. doi: 10.4067/S0034-98872016000900013.
For several years and in many different ways, medical errors have been studied. As expected, the majority of efforts have been directed to prevent clinical errors during the different phases of health care. Nevertheless, less attention has been given to what happens when a negative effect has already occurred. The present work describes the doubts and difficulties that doctors deal with when facing an error and to describe the communicational tools that the literature offers to cope with them. The definition of medical error was the starting point that was used to later analyze the evidence about what, why and how to inform medical errors from an ethical and technical point of view. In the light of new legal exigencies, communicational and health protocols are revised, distinguishing those that are used for conveying bad news and medical errors. The importance of the ethical and communicational formation of the professionals is emphasized, identifying certain hindering aspects of the medical culture. This culture promotes an idea of the doctor as a professional who knows everything, does not make mistakes and acts in isolation. These do not reflect personal attributes in the professional and in the health team, required for a good professional practice.
多年来，人们通过多种方式对医疗差错进行了研究。不出所料，大部分工作都致力于在医疗保健的不同阶段预防临床差错。然而，对于负面效应已经发生时所发生的情况却较少关注。本研究描述了医生在面对差错时所面临的疑问和困难，并介绍了文献中提供的应对这些问题的沟通工具。医疗差错的定义是出发点，随后用于从伦理和技术角度分析关于告知医疗差错的内容、原因及方式的证据。鉴于新的法律要求，对沟通和健康协议进行了修订，区分了用于传达坏消息和医疗差错的协议。强调了专业人员伦理和沟通培训的重要性，识别了医疗文化中的某些阻碍因素。这种文化塑造了一种医生形象，即认为医生是无所不知、不会犯错且独自行动的专业人员。这些观念并未反映出专业人员和医疗团队中对于良好专业实践所必需的个人特质。
