Remember that the health care system is quite distinct in its complexity. Health care workers are placed in systems and settings where errors are bound to happen. For example, health care workers are sometimes expected to work 24-hour shifts to ensure patients are cared for and have some continuity of care, although it is known that overwork and fatigue lead to decreased mental concentration and alertness. Caregivers are expected to function in an environment that is not designed for optimal work performance. Finally, they are expected to work in a climate where one error, even if not preventable, may mean a catastrophe or the end of a career.
Physicians have an ethical obligation to tell patients about significant medical errors.
Disclosing a mistake is almost always the right thing to do, except in rare instances where disclosure would cause immediate harm to the patient. Disclosing any kind of mistake to anyone is never easy. Medical errors should be preventable. Many of these adverse events are associated with the use of pharmaceuticals, and are potentially preventable. The IOM estimates the number of lives lost to preventable medication errors alone represents over 7,000 deaths annually-more than the number of Americans injured in the workplace each year.