Making Amends misses the point
http://www.100md.com
《英国医生杂志》
EDITOR—Making Amends says that NHS staff should inform patients of negligent acts.1 2 The chief medical officer's sweetening of the proposed duty of candour with an exemption from disciplinary action if reporting issues of patient safety is well intentioned but wrong.
Every doctor tries to do his or her best to provide good quality care to his or her patients. As doctors, we would be insulted if people were to think that we need to be made less accountable for us to do what any responsible professional should, which is to act in the best interests of patients. Reporting adverse events and errors so that these can be investigated when necessary, and learnt from when possible, is clearly in the best interests of patients' safety.
Of course, it would help secure the maximum compliance with reporting procedure if health professionals could have confidence that when reporting adverse events and near misses they would not face unreasonable consequences as a result. That is already a principle supported by patients' and doctors' groups alike, and an integral part of the "charter of understanding between doctors and people affected by medical accidents," which the charity Action Against Medical Accidents (AvMA) launched with our assistance last year.
We strongly endorse the charity's view that an open and fair culture can be achieved without sacrificing professional accountability or damaging public confidence by providing unnecessary and inappropriate exemptions. Growing support for the charter of understanding and the emerging success of new initiatives to help maintain standards, such as the National Clinical Assessment Authority, which offers retraining to underperforming doctors before suspension becomes an issue, are reassuring signs that a fairer more open culture in medicine is developing.
Michael Baum, emeritus professor of surgery
University College London Portland Hospital, London W1W 5SN michael@mbaum.freeserve.co.uk
Additional authors are: Alun Elias-Jones, Brian Hurwitz, Donald Irvine, Graham Neale, Umesh Prabhu—all members of Action against Medical Accidents (AvMA) doctors' group.
Competing interests: All authors are members of Action Against Medical Accidents (AvMA); MB is the chair.
References
Dyer C. NHS staff should inform patients of negligent acts. BMJ 2003;327: 7.
Department of Health. Making amends. London: DoH, 2003.
Every doctor tries to do his or her best to provide good quality care to his or her patients. As doctors, we would be insulted if people were to think that we need to be made less accountable for us to do what any responsible professional should, which is to act in the best interests of patients. Reporting adverse events and errors so that these can be investigated when necessary, and learnt from when possible, is clearly in the best interests of patients' safety.
Of course, it would help secure the maximum compliance with reporting procedure if health professionals could have confidence that when reporting adverse events and near misses they would not face unreasonable consequences as a result. That is already a principle supported by patients' and doctors' groups alike, and an integral part of the "charter of understanding between doctors and people affected by medical accidents," which the charity Action Against Medical Accidents (AvMA) launched with our assistance last year.
We strongly endorse the charity's view that an open and fair culture can be achieved without sacrificing professional accountability or damaging public confidence by providing unnecessary and inappropriate exemptions. Growing support for the charter of understanding and the emerging success of new initiatives to help maintain standards, such as the National Clinical Assessment Authority, which offers retraining to underperforming doctors before suspension becomes an issue, are reassuring signs that a fairer more open culture in medicine is developing.
Michael Baum, emeritus professor of surgery
University College London Portland Hospital, London W1W 5SN michael@mbaum.freeserve.co.uk
Additional authors are: Alun Elias-Jones, Brian Hurwitz, Donald Irvine, Graham Neale, Umesh Prabhu—all members of Action against Medical Accidents (AvMA) doctors' group.
Competing interests: All authors are members of Action Against Medical Accidents (AvMA); MB is the chair.
References
Dyer C. NHS staff should inform patients of negligent acts. BMJ 2003;327: 7.
Department of Health. Making amends. London: DoH, 2003.