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医疗差错的认知:进行公开披露为时未晚——一篇叙述性综述

Recognition of medical error: It is not too late for an open disclosure - a narrative review.

作者信息

Miziara Ivan Dieb, Miziara Carmen Silvia Molleis Galego

机构信息

Full Professor of Legal Medicine, Bioethics, and Occupational Health, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.

Assistant Professor of Legal Medicine, Faculdade de Medicina ABC, Santo André, SP, Brazil.

出版信息

Clinics (Sao Paulo). 2025 Mar 18;80:100622. doi: 10.1016/j.clinsp.2025.100622. eCollection 2025.

Abstract

A medical error is a preventable adverse effect of medical care. These errors are usually avoidable. They are a vast source of ethical, financial, and even mental problems affecting patients, physicians, and healthcare organizations. The negative impact on patients can be physical, generating sequelae or disability. It could lead to a loss of trust in the patient and his family in the doctor or the hospital where he has been treated. On the other hand, doctors resist disclosing their errors to the patient, fearing lawsuits and financial losses. Disclosure errors are also an imperative moral duty. In this narrative review, the authors discuss obstacles that exist and prevent an adequate open disclosure, including flaws in medical education, and propose ten steps to proceed with an open disclosure if a medical error occurs.

摘要

医疗差错是医疗护理中可预防的不良后果。这些差错通常是可以避免的。它们是影响患者、医生和医疗保健机构的伦理、财务甚至心理问题的巨大根源。对患者的负面影响可能是身体上的,产生后遗症或残疾。这可能导致患者及其家属对治疗他们的医生或医院失去信任。另一方面,医生因担心诉讼和经济损失而不愿向患者披露他们的差错。披露差错也是一项紧迫的道德义务。在这篇叙述性综述中,作者讨论了存在的阻碍充分公开披露的障碍,包括医学教育中的缺陷,并提出了如果发生医疗差错进行公开披露的十个步骤。

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