Public preferences and attitudes towards the disclosure of medical errors: a survey in Iran

  • Akram Heidari Assistant Professor Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran.
  • Masoomeh Razaghi Researcher Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran.
  • Fariba Asghari Associate Professor Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Keywords: Medical error, Disclosure, Consumer preferences

Abstract

Awareness of the occurrence of medical errors is the right of patients and duty of the health service providers. This study was conducted to evaluate to what extent people want to know the occurrence of an error in their medical care, what they expect to be disclosed about medical error, and what are the influential factors in filing a lawsuit against physicians in disclosed medical errors from their point of view.  In this cross-sectional survey, 1062 people residing in the city of Qom, Iran, were telephone interviewed using the random digit dialing method. The questionnaire used consisted of 4 demographic questions and 2 scenarios of major and minor medical error; the participants were asked if the physician should disclose the error in each scenario. The questionnaire also consisted of 16 questions about other issues related to error disclosure. Data were analyzed through descriptive and inferential statistics in SPSS software. About 99.1% of the study population believed that errors had to be disclosed to patients. They all wished to know that measures would be taken to prevent further errors. Moreover, 93.1% of the participants expected an explanation on the incident. As for the factors that decreased the likelihood of taking legal action against the physician from the viewpoint of the study population, treatment of the complications (96.1%) and honesty of the physician (95.8%) had the highest frequency. Based on the considerable preference of patients for error disclosure, it is recommended that physicians disclose all minor and major errors sympathetically and with transparency, honesty, and efforts to prevent future errors.

Author Biographies

Akram Heidari, Assistant Professor Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran.
Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran.
Masoomeh Razaghi, Researcher Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran.
Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran.
Fariba Asghari, Associate Professor Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.

References

1. Grober ED, Bohnen JM. Defining medical error. Can J Surg. 2005; 48(1): 39-44.
2. Brennan TA, Leape LL, Laird NM, et al. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard medical practice study I.1991. Qual Saf Health Care. 2004;13(2):145-51.
3. Forster AJ, Asmis TR, Clark HD, et al. Ottawa hospital patient safety study: incidence and timing of adverseevents in patients admitted to a Canadian teaching hospital. CMAJ. 2004; 170(8): 1235-40.
4. Chan DK, Gallagher TH, Reznick R, Levinson W. How surgeons disclose medical errors to patients: a studyusing standardized patients. Surgery. 2005; 138(5): 851-8.
5. Coffey M, Espin S, Hahmann T, et al. Parent preferences for medical error disclosure: a qualitative study.Hosp Pediatr. 2017; 7(1): 24-30.
6. Matlow AG, Moody L, Laxer R, Stevens P, Goia C, Friedman J. Disclosure of medical error to parents andpaediatric patients: assessment of parents' attitudes and influencing factors. Arch Dis Child. 2010; 95(4):286-90.
7. Norrish MI. Disclosure of medical errors in Oman: public preferences and perceptions of current practice.Sultan Qaboos Univ MedJ. 2015; 15(2): e283-7.
8. Ushie B, Salami K, Jegede A, Oyetunde M. Patients’ knowledge and perceived reactions to medical errors ina tertiary health facility in Nigeria. Afr Health Sci. 2013; 13(3): 820-8.
9. Mazor KM, Simon SR, Yood RA, et al. Health plan members' views about disclosure of medical errors. AmJ Manag Care. 2005;11(1):49-52.
10. Hobgood C, Tamayo-Sarver JH, Elms A, Weiner B. Parental preferences for error disclosure, reporting, andlegal action after medical error in the care of their children. Pediatrics. 2005; 116(6): 1276-86.
11. Hobgood C, Peck CR, Gilbert B, Chappell K, Zou B. Medical errors—what and when: what do patientswant to know? Acad Emerg Med. 2002; 9(11): 1156-61.
12. Al-Nomay NS, Ashi A, Al-Hargan A, Alshalhoub A, Masuadi E. Attitudes of dental professional staff and auxiliaries in Riyadh, Saudi Arabia, toward disclosure of medical errors. Saudi Dent J. 2017; 29(2): 59-65.
13. Hs AS, Rashid A. The intention to disclose medical errors among doctors in a referral hospital in North Malaysia. BMC Med Ethics. 2017; 18(1): 3.
14. Bari A, Khan RA, Rathore AW. Medical errors; causes, consequences, emotional response and resulting behavioral change. Pak J Med Sci. 2016; 32(3): 523-8.
15. Mazor K, Roblin DW, Greene SM, Fouayzi H, Gallagher TH. Primary care physicians’ willingness to disclose oncology errors involving multiple providers to patients. BMJ Qual Saf. 2016; 25(10): 787-95.
16. Ghalandarpoorattar SM, Kaviani A, Asghari F. Medical error disclosure: the gap between attitude and practice. Postgrad Med J. 2012; 88(1037): 130-3.
17. Loren DJ, Klein EJ, Garbutt J, et al. Medical error disclosure among pediatricians: choosing carefully what we might say to parents. Arch PediatrAdolesc Med. 2008; 162(10): 922-7.
18. Levinson W. Disclosing medical errors to patients: a challenge for health care professionals and institutions. Patient Educ Couns. 2009; 76(3): 296-9.
19. Mardani Hamooleh M, Shahraki Vahed A. The obstacles in reporting nursing error: a nurses’ perspective. Medical Ethics and History of Medicine. 2009; 2(4): 55-62.
20. Waksberg J. Sampling methods for random digit dialing. Journal of the American Statistical Association.1978; 73(361): 40-6.
21. Lavrakas PJ. Encyclopedia of Survey Research Methods. USA: Sage Publications; 2008, pp. 716-19.
22. Nazione S, Pace K. An experimental study of medical error explanations: do apology, empathy, corrective action, and compensation alter intentions and attitudes? J Health Commun. 2015; 20(12): 1422-32.
23. Blendon RJ, DesRoches CM, Brodie M, et al. Views of practicing physicians and the public on medical errors. N Engl J Med. 2002; 347(24): 1933-40.
24. Schwappach DL, Koeck CM. What makes an error unacceptable? A factorial survey on the disclosure of medical errors. Int J Qual Health Care. 2004; 16(4): 317-26.
25. Witman AB, Park DM, Hardin SB. How do patients want physicians to handle mistakes?: A survey of internal medicine patients in an academic setting. Arch Intern Med. 1996; 156(22): 2565-9.
26. Cleopas A, Villaveces A, Charvet A, Bovier P, Kolly V, Perneger T. Patient assessments of a hypothetical medical error: effects of health outcome, disclosure, and staff responsiveness. Qual Saf Health Care. 2006;15(2): 136-41.
27. Perez B, Knych SA, Weaver SJ, et al. Understanding the barriers to physician error reporting and disclosure:a systemic approach to a systemic problem. J Patient Saf. 2014; 10(1): 45-51.
Published
2018-08-04
How to Cite
1.
Heidari A, Razaghi M, Asghari F. Public preferences and attitudes towards the disclosure of medical errors: a survey in Iran. J Med Ethics Hist Med. 11.
Section
Original Article(s)