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Published on: February 16, 2011
Delivering the truth: challenges and opportunities for error disclosure in obstetrics
Leslie Carranza1, Anne Drapkin Lyerly, Lauren Lipira
1Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, California; Social Medicine, Center for Bioethics, Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and the Departments of General Internal Medicine, Neonatology, and Medicine, Bioethics & Humanities, University of Washington, Seattle, Washington.
Abstract:
Disclosing harmful medical errors to patients is a prominent component of the patient safety movement. Patients expect it and safety agencies and experts advocate its implementation. Obstetrics presents unique challenges to carrying out disclosure recommendations: childbirth is a life-changing, emotionally charged, and dynamic family event characterized by high expectations and unpredictability, and perinatal care is provided by complex ad hoc teams in a litigious area of medicine. Despite these challenges, transparent communication with parents about unexpected adverse birth outcomes remains critical. We call on clinicians and professional societies to pursue a deeper understanding of the unique challenges of disclosure in obstetrics and prepare themselves to conduct these difficult conversations well.
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