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Recent literature on the ethics of medical error disclosure acknowledges the feelings of injustice, confusion, and grief patients and their families experience as a result of medical error. Substantially less literature acknowledges the emotional and relational discomfort of the physicians responsible or suggests a meaningful way forward. To address these concerns more fully, I propose a model of medical error disclosure that mirrors the theological and sacramental technique of confession. I use Aquinas’ description of moral acts to show that all medical errors are evil, and some accidental medical errors constitute venial sins; all sin and evil should be confessed. As Aquinas urges confession for sins, here I argue that confession is necessary to restore physicians to the community and to provide a sense of absolution. Even mistakes for which physicians are not morally culpable ought to be confessed in order to heal the physician–patient relationship and to address feelings of professional distress. This paper utilizes an Episcopal theology of confession that affirms verbal admission and responsibility-taking as freeing and relationally restoring acts, arguing that a confessional stance toward medical error both leads to better outcomes in physician–patient relationships and is more compassionate toward physicians who err.

The push by some bioethicists to excise religion from the clinical ethics consultative process has received institutional support from the American Society for Bioethics and the Humanities (ASBH). Their certification program, Healthcare Ethics Consultant-Certified (HEC-C), is intended to identify and assess “a national standard for the professional practice of clinical healthcare ethics consulting” devoid of religious content. As Christian ethicists who wish to preserve the morally evaluative nature of healthcare ethics, we must pause and theologically reflect on the meaning of such a program. The five articles in this issue offer rich theological responses to the religion-free standardized methodology endorsed by the ASBH and reified in the HEC-C certification program. They offer a depth of theological reflection we see previously lacking in the literature, attending to the real possibilities of a “terraformed bioethics” effecting metaphysical harm, severing of clinical ethics from its sources, eliminating possibilities for conversion, and confusing the meaning of moral expertise.