Mandatory disclosure of medical errors has been advocated to improve patient safety. At least 20 States have passed laws or regulations mandating that cases of medical errors and/or patient harm be reported to the State. One State, Pennsylvania, also requires disclosure directly to patients and/or families. However, many providers resist mandatory disclosure of errors due to concerns about malpractice suits. A recent review of the literature on the impact of full disclosure on malpractice liability concludes that the jury is still out.
Many studies examine why patients sue their doctors, suggesting that some lawsuits may be averted by disclosure, but the studies do not allow researchers to estimate the additional suits that would be created by disclosure. On the other hand, some studies identified suspicion of a cover-up or the failure to acknowledge an error or apologize for it as major risk factors for malpractice suits. Additional studies addressing the effects of disclosure on malpractice liability are needed.
Arguments in favor of disclosure include reasons of ethics, patient autonomy, and equity, according to Sanjay Saint, M.D., M.P.H., Timothy P. Hofer, M.D., M.Sc., of the VA Center for Practice Management and Outcomes Research, and colleagues. Their research was supported in part by the Agency for Healthcare Research and Quality (HS11540). They conducted an extensive literature search of over 5,200 citations on disclosure and malpractice liability, which yielded only one published study that directly examined malpractice liability when a policy of full disclosure was implemented.
For more information, see "Does full disclosure of medical errors affect malpractice liability?" by Allen Kachalia, M.D., J.D., Kaveh G. Shojania, M.D., Dr. Hofer, and others, in the October 2003 Joint Commission Journal on Quality and Safety 29(10), pp. 503-511.
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