Medical error. Ratings

Arnoldo Kraus

(Doctor and writer)


In 1983, Neil MacIntyre, a professor of medicine, and Karl Popper, a philosopher, wrote an article entitled “A Critical View of Medicine: The Need for a New Ethics.” I translate the opening sentences: “In medicine, as in other professions, mistakes happen. Sometimes the consequences are trivial, but often they are serious, and sometimes they can be catastrophic. A way must be found to correct the errors; unfortunately, in many cases” Sometimes the damage is irreversible. The only benefit that can be gained from a mistake is to avoid it in the future.”

The topic of medical error is a fascinating one. This is true, because it is always necessary to see a doctor. Even mothers who give birth to babies with the help of midwives, due to poverty, adherence to principles or distrust of doctors, sooner or later need the help of a pediatrician for their sons/daughters. For convenience, here are some thoughts:

1. Errare humanum est is an old great idea. Everyone knows: mistakes are human. Learning from mistakes is very important.

2. In Latin, the original expression reads: Errare humanum est, sed perseverare diabolicum, an adequate and reasonable concept: “To err is human, but to persist in error is diabolical.” Medical school should be that idea.

3. Don’t be disobedient, i.e. “remaining firm in one’s behavior, views, ideas, or intentions despite punishment, warnings, or advice” is extremely important in medicine (and in life).

4. There are three sources of learning and growth in medicine: books, patients, experience. Young doctors drink from everything: from books and magazines, theory; patients thanks to the clinic, whose etymological origin comes from the Greek “to care for the sick in bed”, and thanks to experience, thanks to the teaching of teachers. Those who adhere to this triad make fewer mistakes.

5. Criticism is a beautiful word. From the Greek krinen it means “able to discern” as well as “to divide, decide, judge.” He who submits to criticism grows. You improve through your successes and progress as you reflect on your mistakes. In medicine, criticism is necessary.

6. An old practice in medicine is the presentation of clinical cases. It is very important to notice errors and comment on them. Criticism must be harsh. Nepotism should be kept to a minimum when discussing medical errors.

7. Report bugs ethically. Covering them – no. Making mistakes in medicine and looking for ways to solve them is a matter of medical ethics. Nowadays such an attitude is rare. This takes away loyalty to colleagues, to the hospital, to the economy (“you send me patients, I send you patients”) and to drug companies, rather than to the truth.

8. Medical professionalism, “The unwritten contract between physicians and society, the purpose of which is to practice medicine with integrity, compassion and empathy…” must be strengthened. Professionalism adds self-criticism and ethics. Doctors who are attentive to criticism are self-critical; Self-critical doctors adhere to ethical principles.

9. Doctors must be loyal to patients. There are no double standards.

Errors in medicine are common. Mitigating errors depends on self-criticism, the ability to accept criticism, and the ability to listen to patients and colleagues. Medical ethics are strengthened when such relationships are added to the mix.

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