Biomaterial Database

Iatrogenesis: ethical and legal aspects. 2011

Tomas J Silber, and Mary Anne Hilliard

Pediatric Ethics Program, Division of Adolescent Medicine, Children's National Medical Center, USA. tsilber@childrensnational.org

This article describes iatrogenic events, giving examples that range from individual error to systemic malfunctions. It then goes on to analyze individual and system responsibilities in the disclosure of iatrogenic events. A discussion follows on the physician's responsibility, professional integrity, "duty to warn", and transparency as they relate to error disclosure, including an examination of the role of apology and repair in the setting of iatrogenesis. It concludes by considering the moral and legal operational implications of iatrogenic events and the building of a culture of safety.

UI	MeSH Term	Description	Entries
D007049	Iatrogenic Disease	Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment.	Hospital-Acquired Condition,Condition, Hospital-Acquired,Conditions, Hospital-Acquired,Disease, Iatrogenic,Diseases, Iatrogenic,Hospital Acquired Condition,Hospital-Acquired Conditions,Iatrogenic Diseases
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000295	Adolescent Medicine	A branch of medicine pertaining to the diagnosis and treatment of diseases occurring during the period of ADOLESCENCE.	Ephebiatrics,Hebiatrics,Medicine, Adolescent
D014342	Truth Disclosure	Truthful revelation of information, specifically when the information disclosed is likely to be psychologically painful ("bad news") to the recipient (e.g., revelation to a patient or a patient's family of the patient's DIAGNOSIS or PROGNOSIS) or embarrassing to the teller (e.g., revelation of medical errors).	Disclosure, Truth,Disclosure, Error,Disclosures, Error,Disclosures, Truth,Error Disclosure,Error Disclosures,Truth Disclosures
D015279	Organizational Culture	Beliefs and values shared by all members of the organization. These shared values, which are subject to change, are reflected in the day to day management of the organization.	Corporate Culture,Corporate Cultures,Culture, Corporate,Culture, Organizational,Cultures, Corporate,Cultures, Organizational,Organizational Cultures
D016365	Liability, Legal	Accountability and responsibility to another, enforceable by civil or criminal sanctions.	Institutional Liability,Personal Liability,Professional Liability,Legal Liability,Medical Liability,Torts,Institutional Liabilities,Legal Liabilities,Liabilities, Institutional,Liabilities, Legal,Liabilities, Medical,Liabilities, Personal,Liabilities, Professional,Liability, Institutional,Liability, Medical,Liability, Personal,Liability, Professional,Medical Liabilities,Personal Liabilities,Professional Liabilities,Tort
D017751	Safety Management	The development of systems to prevent accidents, injuries, and other adverse occurrences in an institutional setting. The concept includes prevention or reduction of adverse events or incidents involving employees, patients, or facilities. Examples include plans to reduce injuries from falls or plans for fire safety to promote a safe institutional environment.	Hazard Management,Hazard Control,Hazard Surveillance Program,Safety Culture,Control, Hazard,Culture, Safety,Cultures, Safety,Hazard Controls,Hazard Surveillance Programs,Management, Hazard,Management, Safety,Program, Hazard Surveillance,Programs, Hazard Surveillance,Safety Cultures,Surveillance Program, Hazard,Surveillance Programs, Hazard
D019300	Medical Errors	Errors or mistakes committed by health professionals which result in harm to the patient. They include errors in diagnosis (DIAGNOSTIC ERRORS), errors in the administration of drugs and other medications (MEDICATION ERRORS), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Medical errors are differentiated from MALPRACTICE in that the former are regarded as honest mistakes or accidents while the latter is the result of negligence, reprehensible ignorance, or criminal intent.	Medical Mistakes,Surgical Errors,Critical Incidents, Medical,Critical Medical Incidents,Errors, Medical,Errors, Surgical,Medical Error of Commission,Medical Error of Omission,Medical Errors of Commission,Medical Errors of Omission,Medical Mistake,Mistake, Medical,Mistakes, Medical,Never Event,Surgical Error,Wrong-Patient Surgery,Wrong-Procedure Errors,Wrong-Site Surgery,Commission Medical Error,Commission Medical Errors,Critical Incident, Medical,Critical Medical Incident,Error, Medical,Error, Surgical,Error, Wrong-Procedure,Errors, Wrong-Procedure,Event, Never,Events, Never,Incident, Critical Medical,Incident, Medical Critical,Incidents, Critical Medical,Incidents, Medical Critical,Medical Critical Incident,Medical Critical Incidents,Medical Error,Medical Incident, Critical,Medical Incidents, Critical,Never Events,Omission Medical Error,Omission Medical Errors,Surgeries, Wrong-Patient,Surgeries, Wrong-Site,Surgery, Wrong-Patient,Surgery, Wrong-Site,Wrong Patient Surgery,Wrong Procedure Errors,Wrong Site Surgery,Wrong-Patient Surgeries,Wrong-Procedure Error,Wrong-Site Surgeries