1.Here the chain of the events that lead to the patient/ medical error are the following:
a. The stool for occult blood test was never done by the hospital staff.
b. The discharging physician was different from the hospitalist who admitted her.
c. The discharging physician did not schedule an appointment with the primary care provider.
d. Nobody in the primary care providers office reviewed her records of recent hospitalization and primary care provider was unaware of her anemia.
2. The responsibility of the poor outcome in this case lies on heath care providers as whole. Communication breakdown(both verbal and written), inadequate information flow, and human problems etc resulted in the poor outcome of the patient.
3.Many patient risks can be reduced by adequately training physicians and other staffs, encouraging strong communication among staff members, proper documentation, ensuring adequate flow of information between different health settings, patient education and counselling.
4. If I was the care provider, I would have done the stool test for occult blood in the first place, to rule out any possible internal GI bleed. Also I would have ensured a proper follow up for this patient in order to avoid any future complications.
5.The ethical issues related to medical errors can be categorised around 4 ethical principals. Autonomy and right to self determination, beneficence and nonmaleficence, disclosure and right to knowledge, veracity.
Autonomy and right to self determination : this concept acknowledges patients' right to make their choices and to take action based on their views and perceived benefits.
Beneficence and non malefiecence : this directs health care providers to deliver what is best for the patients and to avoid harm.
Disclosure and right to knowledge : health care providers have a ethical obligation to disclose information to the patients so that they can do informed decision making.
Veracity: the principle of veracity requires health care personnel to provide comprehensive and accurate information in a manner that helps the patients to understand the information. Telling the truth about the medical errors helps to establish trust.
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