Journal of medical ethics
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Journal of medical ethics · Dec 2019
Medical error in the care of the unrepresented: disclosure and apology for a vulnerable patient population.
Defined as patients who 'lack decision-making capacity and a surrogate decision-maker', the unrepresented (sometimes referred to as the 'unbefriended', 'isolated patients' and/or 'patients without surrogates') present a major quandary to clinicians and ethicists, especially in handling errors made in their care. A novel concern presented in the care of the unrepresented is how to address an error when there is seemingly no one to whom it can be disclosed. ⋯ Next, it asserts that the ethical obligation to disclose error still exists for the unrepresented because the moral status of error does not change with the presence or absence of surrogate decision-makers. Finally, this paper concludes that in outwardly acknowledging wrongdoing, a clinician or team leader can alleviate significant moral distress, satisfy the standards of a genuine apology, and validate the inherent and equivalent moral worth of the unrepresented patient.