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Ethical Considerations on Disclosure When Medical Error Is Discovered During Medicolegal Death Investigation
Dwayne A Wolf1, Stacy A Drake, Francine K Snow
1From *Harris County Institute of Forensic Sciences and †School of Nursing and ‡The McGovern Center for Humanities & Ethics, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX.
Abstract:
In the course of fulfilling their statutory role, physicians performing medicolegal investigations may recognize clinical colleagues' medical errors. If the error is found to have led directly to the patient's death (missed diagnosis or incorrect diagnosis, for example), then the forensic pathologist has a professional responsibility to include the information in the autopsy report and make sure that the family is appropriately informed. When the error is significant but did not lead directly to the patient's demise, ethical questions may arise regarding the obligations of the medical examiner to disclose the error to the clinicians or to the family. This case depicts the discovery of medical error likely unrelated to the cause of death and describes one possible ethical approach to disclosure derived from an ethical reasoning model addressing ethical principles of respect for persons/autonomy, beneficence, nonmaleficence, and justice.
Insights
Forensic pathologists may uncover medical errors during medicolegal death investigations. This case explores ethical disclosure of errors unrelated to the cause of death, balancing patient rights and professional duties.
Area of Science:
- Forensic Pathology
- Medical Ethics
- Autopsy
Background:
- Physicians conducting medicolegal death investigations may identify medical errors made by clinical colleagues.
- Errors directly causing death necessitate inclusion in autopsy reports and family notification.
Observation:
- This case involves a medical error discovered during an autopsy that was likely unrelated to the patient's cause of death.
- Ethical dilemmas arise concerning the disclosure of significant errors not directly linked to mortality.
Findings:
- The study presents an ethical reasoning model for disclosing medical errors.
- The model integrates principles of respect for persons/autonomy, beneficence, nonmaleficence, and justice.
Implications:
- Provides a framework for forensic pathologists facing ethical decisions on error disclosure.
- Highlights the importance of ethical considerations in medicolegal investigations beyond determining the cause of death.
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