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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

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Are patients morally responsible for their errors?

S Buetow¹, G Elwyn

¹Department of General Practice and Primary Health Care, University of Auckland, Private Bag 92019, Auckland, New Zealand. s.buetow@auckland.ac.nz

Journal of Medical Ethics

|May 2, 2006

Summary

Patients may be morally responsible for medical errors they can avoid or influence. This research explores patient accountability in medical errors, moving beyond solely system-based explanations.

Area of Science:

Medical Ethics
Philosophy of Medicine
Patient Safety

Background:

Current medical error literature focuses on system deficiencies, often overlooking patient contributions.
There's a need to explore the moral responsibility of patients for their role in medical errors.

Purpose of the Study:

To investigate whether patients bear moral responsibility for medical errors.
To define appropriate responses to medical errors by considering patient accountability.

Main Methods:

Analysis of medical error literature from an incompatibilist, agent causation perspective.
Application of H.L.A. Hart's four senses of moral responsibility: role, capacity, causal, and liability responsibility.

Main Results:

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Each of Hart's senses of responsibility contributes to assessing patient accountability for errors.
Patients appear to hold moral responsibility for errors that are avoidable, or to which they contribute or can influence.

Conclusions:

A comprehensive theoretical framework is needed to evaluate patient moral responsibility in medical errors.
Shifting focus solely to system deficiencies neglects the potential for patient agency and responsibility.