On higher ground: Ethical reasoning and its relationship with error disclosure

Alexander Putnam Cole, Lauren Block, Albert W Wu

Research output: Contribution to journalArticle

Abstract

Background There is broad consensus that disclosure of harmful medical errors is vital to improve safety and is ethically required. Although most physicians-in-training are taught ethics, there have been no empirical studies on whether ethical reasoning is related to disclosure.We examined whether scores on a test of ethical reasoning were associated with greater willingness to disclose errors. Methods We conducted a cross-sectional survey of house officers in internal medicine at Johns Hopkins Hospital. Ethical reasoning was assessed using the Defining Issues Test, V.2 (DIT-2). Higher DIT-2 scores are associated with more sophisticated ethical reasoning, and scores tend to improve after formal ethical training. Respondents were then given a medical error scenario with multiple scripted disclosure options. Ethical reasoning scores were compared for different levels of disclosure. Results A total of 29 out of 127 medicine residents completed the survey (response rate=22.8%). The 41%of residents who would explicitly tell a patient that, 'an error happened' had significantly higher DIT-2 scores than those who would not (51.1 vs 31.6, p

Original languageEnglish (US)
Pages (from-to)580-585
Number of pages6
JournalBMJ Quality and Safety
Volume22
Issue number7
DOIs
StatePublished - Jul 2013

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Truth Disclosure
Disclosure
Medical Errors
Internal Medicine
Ethics
Consensus
Cross-Sectional Studies
Medicine
Physicians
Safety

ASJC Scopus subject areas

  • Health Policy

Cite this

On higher ground : Ethical reasoning and its relationship with error disclosure. / Cole, Alexander Putnam; Block, Lauren; Wu, Albert W.

In: BMJ Quality and Safety, Vol. 22, No. 7, 07.2013, p. 580-585.

Research output: Contribution to journalArticle

Cole, Alexander Putnam ; Block, Lauren ; Wu, Albert W. / On higher ground : Ethical reasoning and its relationship with error disclosure. In: BMJ Quality and Safety. 2013 ; Vol. 22, No. 7. pp. 580-585.
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