KARACHI: Hospitals should have monitoring bodies to report, record and thoroughly investigate medical error(s) with the aim of bringing about improvement in the healthcare system. The current practice of naming and shaming individuals by the media must stop and there should be efforts to develop a relationship of trust between doctor and other caregivers.
These points were raised during a session on ‘Medical error: ethics and society’ organised by the Irtiqa institute of Social Sciences on Saturday.
Giving a presentation on the subject, Dr Nida Wahid Bashir, a consultant surgeon and faculty member of the Centre of Biomedical Ethics and Culture at the Sindh Institute of Urology
and Transplantation (SIUT), said it’s important to have the right understanding about the terms used in this discourse and one must differentiate among the terms error, negligence and malpractice.
While an error could be an unintended act leading to adverse events, malpractice was a wrong act done with bad intention, she added.
“We must understand that medical practice is a human practice and any practice involving humans cannot be made error-free. We can minimise the error(s) but we can’t reduce it to zero,” she said.
Medical professionals in other parts of the world also committed error(s) during their practice and it’s absolutely wrong to assume that this happened only in countries like ours, she noted.
“The difference is that other countries have recognised its importance in medical practice and learnt how to deal with it. We can only tackle it once we know its causes and how to draw strategies to deal with it,” she said.
Dr Wahid regretted that while the medical community had been talking about this issue for a long time, it was still a highly misunderstood problem.
People, she pointed out, needed to understand that a good doctor was one whose professional integrity was at stake in the case of an error.
“Such a doctor is the advocate of patient’s wellbeing, and feels responsible for the adverse effects of any medical error. Society must understand the position of doctors and be sympathetic to their situation in case of a medical error,” she noted.
During the discussion, concern was also raised over how the public and the media responded to medical incidents. The media, it was said, sensationalised the issue by jumping to the conclusion and making a few individuals, often doctors, responsible for the errors in the system.
This practice of naming and shaming individuals was very deleterious in understanding what actually went wrong in the case of medical error.
“One quickly forgets that medicine is a whole system of which doctors are only a part. Whenever there is an error there can be many variables which may have contributed to the error.
“An error may have been caused by lack of experience, poor communication or a fault at the level of other individuals involved in the whole process of health care service. A medical error can only be understood if we put the error in the context of the system which provides this service,” explained Dr Wahid.
It’s because of this flawed approach that most of the times institutions and doctors found it hard to disclose such mistakes. This further exacerbated the problem.
It was suggested that the first step was to have a proper record of these events at institutions in order to minimise medical error(s). And society should make institutions and government bodies accountable for such errors.
Prof Bushra Shirazi of SIUT’s Centre of Biomedical Ethics and Culture participated in the question-answer session.
Published in Dawn, July 29th, 2019