(HealthDay News) — Pediatric physicians should disclose their errors to patients and their families, according to an ethics rounds paper published online December 1 in Pediatrics.

Sigall K. Bell, MD, from the Beth Israel Deaconess Medical Center in Boston, and colleagues discuss the emotional and ethical issues that arise when a doctor realizes they have made an error that has harmed a patient. The authors illustrate the topic using a case report of a 4-month-old former 23-week preterm infant who had a malpositioned central line that caused complications resulting in severe neurological injury.

Bell and colleagues note that many professional organizations now recommend full disclosure of mistakes and apologies for any harm caused. Professional norms require openness and transparency in almost all cases. In preparing for the ideal disclosure process, all interprofessional providers involved in the error should be informed. An interprofessional team approach is recommended for the disclosure conversation, including specialists and team members; this inclusiveness must be balanced against the importance of not overwhelming the family and the potential time lag for coordinating providers. In some complex cases, a smaller initial conversation is preferable, including someone with a close relationship to the family. Conversations with the family should take place immediately after an unexpected event, even if there is not a clear understanding of what happened, thus allowing trust to develop.

“Today, there is universal agreement, at least in theory, that we must tell patients and families about mistakes,” the authors write. “Today, when disclosure does not occur, it is simply because such disclosure is psychologically difficult for doctors to do.”

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