In 1983, Neil MacIntyre, a professor of medicine, and philosopher Karl Popper wrote an article entitled “The Critical Stance in Medicine: The Need for a New Ethics.” I translate the opening sentences: “In medicine, as in other professions, mistakes happen. Sometimes the consequences are trivial, but more often they are serious, and at other times they can be disastrous. A way must be found to correct the mistakes; unfortunately, In many cases the damage is irreparable. The only benefit that can be derived from the mistake is to avoid it in the future.
The topic of “error in medicine” is fascinating. This is because it is always necessary to go to the doctor. Even mothers who deliver their babies with the help of midwives, for example poverty, due to principles or distrust of doctors, sooner or later they need the help of a pediatrician for their sons/daughters. For convenience, here are some thoughts:
1. Human error is a great old idea. Everyone knows that: to err is human. Learning from mistakes is essential.
2. In Latin, the original expression reads: Errare humanum est, sed perseverare diabolicum, which is an apt and clever concept: “To err is human, but to persist in error is diabolical.” This idea should be medical school.
3. Non-aggression, i.e. “remaining consistent in your behavior, attitude, thoughts, or intentions despite punishments, warnings, or advice,” in medicine (and in life) is essential.
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4. There are three sources through which a person learns and grows in medicine: From books, from patients, from experience. Young doctors drink it all: from theoretical books and journals; From patients thanks to the clinic, whose origin comes from the Greek, “caring for the sick in bed”, and from experience, thanks to the teachings of teachers. Whoever adheres to this triad makes fewer mistakes.
5. Criticism is a beautiful word. From the Greek word krinen, meaning “able to discern”, as well as “to separate, decide, judge”. He who submits to criticism grows. You improve from your successes and move forward when you reflect on your mistakes. In medicine, criticism is necessary.
6. The ancient practice in medicine is to present clinical cases. Noticing and commenting on errors is essential. Criticism must be strong. When discussing medical errors, favoritism should be minimized.
7. Reporting errors is ethical. Covering them up is not. Making mistakes in medicine and looking for ways to solve them is related to medical ethics. Nowadays this situation is uncommon. It forbids loyalty to colleagues, to the hospital, to the economy – “You send me patients, I send you patients” – and to pharmaceutical companies, not to the truth.
8. Medical professionalism, “the unwritten contract between doctors and society that aims to practice medicine with integrity, compassion and empathy…” must be strengthened. Professionalism adds self-criticism and ethics. Doctors who care about criticism criticize themselves. Self-critical physicians are committed to ethical principles.
9. Doctors must be loyal to their patients. There are no double standards.
Making mistakes in medicine is common. Reducing mistakes depends on a self-critical attitude. Knowing how to be a recipient of criticism and being able to listen to patients and colleagues. Medical ethics is strengthened when these situations are added.
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