Evaluating the efficacy and accuracy of clinical reasoning and distinguishing between complications and medical errors is a difficult task. However, it seems to be an even more difficult task to provide models for systematically reporting and reducing those errors through improvements in the entire web of healthcare delivery. The report “To Err Is Human: Building a Safer Health System” published in 1999 highlighted the importance of patient safety and proposed some interventions. However, a follow up by the authors of the report in 2005 stated that progress in matters of safer care delivery and improved communications was slow. The interventions proposed include “pay for performance” incentives, implementation of electronic health records, diffusion of safe practices and team training for full disclosure of medical errors to patients following injury. As patients increasingly are consumers, customers and regulatory actors in their own healthcare, it becomes harder to hide medical mistakes in clinical encounters. Explaining why and how the medical error happened, giving informed assurance that the mistake will be avoided in the future and offering sincere apologies to patients and families are skills that need to be taught to medical students as early as the undergraduate level. Those skills are very difficult to teach in the university environment and would be learned more effectively with years of experience. However, structured educational programs focusing in the necessity and components of a good medical error disclosure would improve awareness in the importance of an effective and honest doctor–patient relationship. In this review paper, we compare international literature and examples from Turkey with regard to disclosure of medical errors. The Turkish literature on malpractice cases is rich and most of them point out that medical errors occur because of heavy workloads, insufficient infrastructure and lack of high quality medical education. However, the lack of any papers on medical disclosure to patients in Turkey seems to point out to the big communication gap between patients and doctors, among other reasons. We will address some of the reasons for such lack in Turkey and present recommendations about how to disclose medical errors to patients such as implementation of electronic medical error disclosure systems, education and training, and legislation.
Sensor-based diagnostics are increasing rapidly and in clinics, they can transform the health care as they will be in use out of clinics as well, namely, by the non-clinicians and people without expertise. The trade-off between the advantages and disadvantages of their implementation into the clinical settings should be decisive in their use, at the current state. Yet, disadvantages must be carefully worked out and tried to be eliminated in any case, while keeping the inborn benefits. Therefore, we would like to draw attention to the reliability and security risks of personal health data and associated concerns. We further discuss the related issues of sensor-based diagnostics, mobile health (mHealth) and eHealth. The debate starts with the current states of the rules and regulations. It is argued that there is prompt need for internationally consolidated solutions for vast device types and uses onto which the local needs may have to be implemented without violating the basic assets such as the inherent privacy rights of the users/patients. The resistance factors against the sensor-based healthcare devices and applications are also conferred. There are additionally data quality and assessment issues, and in relation to the data assessment, concerns that are associated with the psychological responses of the layman to the health data are mentioned. For these and more reasons, and finally for proper use and implementation of sensor-based tests and devices in the clinical settings, education of both professionals and non-professionals seems to be the key. All these require much work and maybe even more workforces to be allocated for the emerging, associated tasks. However, there are economic benefits, and beyond those, they bring new features in the health care that were deemed to be impossible. Besides, despite the apparent unethical use risks, they can result in better ethical practices, e.g., possible prevention of unnecessary tests on animals when similar test on organ-on-chips would be failing.
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