Ethics Conflicts in Rural Communities: Recognizing and Disclosing Medical Errors

This chapter explores the ethical responsibility of health care providers to administer safe clinical care. It further explores the challenges that such providers can experience in recognizing, reporting, and disclosing medical errors. Medical errors can cause serious harm (to the patient, provider and institution or clinic) and can prove to be expensive, stressful, time-consuming, and personally devastating. While rural health care providers frequently underscore their desire to provide safe care, they also report that it is very difficult to develop and implement strategies that reduce the risk of making errors. Studies show that there is limited agreement among health care providers when defining, reporting, disclosing, or resolving error. Providers who wish to actively pursue strategies that heighten safety may become inhibited by this lack of agreement. This chapter presents findings from empirical ethics studies involving rural participants from 14 states. These studies shed light on the ethics issues surrounding medical errors that occur in physicians’ offices and hospitals. The two case examples that this chapter presents reflect both the experiences of rural health care providers, and the complexities that can accompany the search for ethically-attuned processes for error disclosure and resolution. 234 Common Ethics Issues in Rural Communities