Research: Consent, Trust & Error
Understanding a patient's level of capacity (also known as competency) is crucial to health care workers in determining whether to follow the patient's treatment wishes or those of a substitute decision-maker. While easy to define, capacity is difficult to measure in practice. Edward Etchells, funded by the Physicians' Services Incorporated Foundation, developed and evaluated the Aid for Capacity Evaluation. The research was published in the Journal of General Internal Medicine, incorporated into the Royal College of Physicians and Surgeons of Canada Bioethics Education curricula, and incorporated into the regulations of consent legislation in Prince Edward Island.
Martin McKneally and colleagues study ethical issues related to surgical care, teaching and research. Themes include the influence of trust on the surgeon-patient relationship, the ethical obligations of surgical teams, innovations in surgical care-such as artificial lungs and hearts, and the management of conflicts of interest in surgical research.
Recent research has shown that error is not uncommon in healthcare and can have adverse outcomes. How we should respond to error, both in terms of disclosure and in terms of reporting - which leads to prevention - will enhance future patient safety. There are very few, if any, institutional policies on this issue, so Philip Hebert and colleagues at Sunnybrook & Women's College Health Sciences Centre have developed a policy related to disclosure and reporting of error.
- Sunnybrook Policy: Disclosure of Adverse Medical Events and Unanticipated Outcomes of Care
This work both improves communication on this issue between health care providers and patients, and increases the reporting of error and, consequently, efforts to fix what went wrong and prevent it in the future.