WBR0744

Author	[[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Serge Korjian)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Ethics
Sub Category	SubCategory::Gastrointestinal
Prompt	[[Prompt::A 22-year-old man presents to the emergency department complaining of acute abdominal pain and tenderness. Following initial work-up, he is diagnosed with appendicitis and is cleared for appendectomy. Rushed by the high patient load, the surgeon accidentally performs the appendectomy on a patient admitted for cholecystectomy. What is the best way to approach this mistake?]]
Answer A	AnswerA::The surgeon should inform the patient that a mistake has been made.
Answer A Explanation	AnswerAExp::The surgeon is ethically bound to disclose the mistake to the patient.
Answer B	AnswerB::The surgeon should inform the patient's parents that a mistake has been made.
Answer B Explanation	AnswerBExp::The patient is an adult; the surgeon must maintain confidentiality with his patient and only the patient has the right to know of the surgeon's mistake.
Answer C	AnswerC::The surgeon is not required to inform the patient of the mistake if cholecystectomy is later performed during the same surgical procedure.
Answer C Explanation	AnswerCExp::The surgeon is ethically obliged to inform the patient, regardless of how benign or how reversible the mistake is.
Answer D	AnswerD::The surgeon may elect not to inform the patient
Answer D Explanation	AnswerDExp::The surgeon is ethically obliged to inform the patient.
Answer E	AnswerE::The surgeon must inform the patient that a mistake has been made and offer monetary compensation.
Answer E Explanation	AnswerEExp::The surgeon is supposed to inform the patient without directly offering any compensation for the mistake. However, in some cases, reimbursement by the hospital to the patient is required.
Right Answer	RightAnswer::A
Explanation	[[Explanation::Regardless of how benign or how serious a medical error is, disclosure of that error and a clear explanation of the circumstances that led to it is an ethical obligation. The physician must also be clear about the severity of the error and what consequences may arise from it. In the case of an adult patient (above 18 years of age), the physician must only share the information with the patient himself; involvement of a third party is considered a breach to the patient's confidentiality. In some cases, the hospital may offer reimbursement to the patient; however, the physician is never to offer monetary compensation to the patient. Educational Objective: A physician must always inform the patient when a medical error is made. References: Association AM. Code of Medical Ethics, 2014-2015. Amer Medical Assn; 2014.]]
Approved	Approved::Yes
Keyword	WBRKeyword::Medical ethics, WBRKeyword::Medical error, WBRKeyword::Ethical, WBRKeyword::Disclosure, WBRKeyword::Error, WBRKeyword::Confidentiality
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