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Doctors' code: try to do no harm, but be prepared to report errors

Each community has its own peculiar moral code. There is nothing inherently wrong with that. After all, in many respects it is laudable to live by such a code. When the group's code is counter to the interests of others, however, problems can arise.

For example, if a doctor is reluctant to report the mistakes of a colleague, that may be understandable on a personal level. But it is also objectionable on a professional level because disclosing errors is necessary in order to help individual patients and improve overall patient safety.

As we discussed in our recent article on the reporting of medical mistakes, the medical profession needs to develop guidelines on when and how doctors should report errors by their colleagues.

No one expects an individual doctor to set himself or herself up as self-appointed grand inquisitor to pass unsolicited judgment on colleagues. Meddling without having adequate facts is a recipe for miscommunication and fractured relationships.

But many doctors work in group practices. And when they become aware that a colleague may have committed a medical mistake, that suspicion should not be swept under the rug.

To be sure, it may become necessary to have a difficult conversation with a colleague, trying to establish what happened. But initiating, or being open to, such conversations should be seen as part of a shared responsibility of the medical community to focus on what is best for patient care.

In short, doctors need to do more to integrate transparency about errors into their profession's ethical code. That code is of course expressed in the Hippocratic Oath, which counsels physicians to "first, do no harm."

"First, do no harm" remains valid advice, 2500 years after Hippocrates first codified it. But doctors should be afraid to risk harm to each other's feelings in raising questions about possible medical errors.

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