Open Disclosure: Ethical, professional and legal obligations, and the way forward for regulation

● Author - Angus F Finlay (medical student), Cameron L Stewart (professor and director), Malcolm Parker
(professor of medical ethics)
● Sort of Article- opinion piece
● Author’s Point of View/ Conclusions
○ Open disclosure should be ethically mandated in systems that value honesty and transparency
○ There may be a need for greater statutory protection of doctors so they are more comfortable
with open disclosure
○ Doctors are more concerned with professional obligations, medicolegal risk as well as
embarrassment with open disclosure
○ Implentation of blanket covers, protection from insurers (voiding contracts), and insertion of
obligations within different bureaucratic structures within the health system
● Evidence
○ Wrighton vs. Arton → sustained nerve injury during surgery → would’ve improved prognosis
○ Small trials of OD in the US → reduced litigation
○ Dovuro vs. Wilkins → admissions of negligence are of little value in coming to the conclusion
○ Hospital and health boards regulation 2012 QLD
● My views
○ Considering the potential for further complications to detrimentally impact on patient care open
disclosure is important so the patient can then be involved in the decision making process of
remedying the incident
○ Should only be done when well established without causing an unnecessary stress
○ Medical practitioners should be better informed and educated in navigating this field and
ultimately delivering statements in a sincere but professional matter
● Further research
○ Patient’s views?
○ Impact on litigation - statistics?
● Other stakeholder’s views
○ Legal representatives?
○ Families of patients - stresses, concerns
● What other questions

Apology laws and open disclosure

● Author - Stuart R McLennan (MBHL Research Assistant); Robert D Truog (MD, Director of Clinical
Ethics)
● Sort of Article -opinion piece
● Author’s Point of View/ Conclusions
○ Culture of secrecy and blame; lack of confidence in communication skills; shame, humiliation
○ Expressions of compassion and solidarity appropriate after a tragic outcome
○ Inadmissability of apologies may fuel public cynicism to the medical profession
○ Preparation through training and education for open disclosure; Support for medical
professionals during open disclosure process
● Evidence
○ Open disclosure standard review report → courts don’t find admissions as liability
● My views
○ Normalisation of open disclosure could diminish the culture of secrecy and blame; shame etc.
○ Education + training → address communication skills required, develop and build and
confidence
○ Open disclosures are emotionally appropriate
○ Despite cynism inadmissability important to ensure more medical professionals are comfortable